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Central coherence in eating disorders: a systematic review

Published online by Cambridge University Press:  30 April 2008

C. Lopez*
Affiliation:
Division of Psychological Medicine, Eating Disorders Research Unit, Institute of Psychiatry, King's College London, London, UK
K. Tchanturia
Affiliation:
Division of Psychological Medicine, Eating Disorders Research Unit, Institute of Psychiatry, King's College London, London, UK
D. Stahl
Affiliation:
Department of Biostatistics and Computing, Institute of Psychiatry, King's College London, London, UK
J. Treasure
Affiliation:
Eating Disorders Research Unit, Department of Academic Psychiatry, King's College London, London, UK
*
*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)

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.

Type
Review Article
Copyright
Copyright © 2008 Cambridge University Press

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References

Baron-Cohen, S, Hammer, J (1997). Parents of children with Asperger syndrome: what is the cognitive phenotype? Journal of Cognitive Neuroscience 9, 548554.CrossRefGoogle ScholarPubMed
Basseches, HI, Karp, SA (1984). Field dependence in young anorectic and obese women. Psychotherapy and Psychosomatics 41, 3337.CrossRefGoogle ScholarPubMed
Bayless, J, Kanz, J, Moser, D, McDowell, B, Bowers, W, Andersen, A, Paulsen, J (2002). Neuropsychological characteristics of patients in a hospital-based eating disorder program. Annals of Clinical Psychiatry 14, 203207.CrossRefGoogle Scholar
Begg, CB, Mazumdar, M (1994). Operating characteristics of a rank correlation test for publication bias. Biometrics 50, 10881101.CrossRefGoogle Scholar
Booth, R (2006). Local–Global Processing and Cognitive Style in Autism Spectrum Disorders and Typical Development. Institute of Psychiatry, King's College London: London.Google Scholar
Bowers, W (1994). Neuropsychological impairment among anorexia nervosa and bulimia patients. Eating Disorders: The Journal of Treatment and Prevention 2, 4246.CrossRefGoogle Scholar
Bradburn, MJ, Deeks, JJ, Altman, DG (1998). sbe24: metan – an alternative meta-analysis command. Stata Technical Bulletin 44, 115.Google Scholar
Bradley, SJ, Taylor, MJ, Rovet, JF, Goldberg, E, Hood, J, Wachsmuth, R, Azcue, MP, Pencharz, PB (1997). Assessment of brain function in adolescent anorexia nervosa before and after weight gain. Journal of Clinical and Experimental Neuropsychology 19, 2033.CrossRefGoogle ScholarPubMed
Bulik, CM, Hebebrand, J, Keski-Rahkonen, A, Klump, KL, Reichborn-Kjennerud, T, Mazzeo, SE, Wade, TD (2007). Genetic epidemiology, endophenotypes, and eating disorder classification. International Journal of Eating Disorders 40, S52S60.CrossRefGoogle ScholarPubMed
Cooper, H, Hedges, L (1994). The Handbook of Research Synthesis. The Russell Sage Foundation: New York.Google Scholar
Dura, JR, Bornstein, RA (1989). Differences between IQ and school achievement in anorexia nervosa. Journal of Clinical Psychology 45, 433435.3.0.CO;2-X>CrossRefGoogle ScholarPubMed
Egger, M, Smith, GD, Schneider, M, Minder, C (1997). Bias in meta-analysis detected by a simple, graphical test. British Medical Journal 315, 629634.CrossRefGoogle ScholarPubMed
Everitt, BS (2003). Modern Medical Statistics. Arnold Publishers: London.Google Scholar
Flexer, BK, Roberge, JJ (1980). IQ, field dependence–independence, and the development of formal operational thought. Journal of General Psychology 103, 191201.CrossRefGoogle Scholar
Fox, C (1981). Neuropsychological correlates of anorexia nervosa. International Journal of Psychiatry in Medicine 11, 285290.CrossRefGoogle ScholarPubMed
Frith, U (1989). Autism: Explaining the Enigma. Basil Blackwell: Oxford.Google Scholar
Galderisi, S, Mucci, A, Monteleone, P, Sorrentino, D, Piegari, G, Maj, M (2003). Neurocognitive functioning in subjects with eating disorders: the influence of neuroactive steroids. Biological Psychiatry 53, 921927.CrossRefGoogle ScholarPubMed
Gillberg, I, Gillberg, C, Rastam, M, Johansson, M (1996). The cognitive profile of anorexia nervosa: a comparative study including a community-based sample. Comprehensive Psychiatry 37, 2330.CrossRefGoogle ScholarPubMed
Gillberg, I, Rastam, M, Wentz, E, Gillberg, C (2007). Cognitive and executive functions in anorexia nervosa ten years after onset of eating disorder. Journal of Clinical and Experimental Neuropsychology 29, 170178.CrossRefGoogle ScholarPubMed
Gordon, DP, Halmi, KA, Ippolito, PM (1984). A comparison of the neuropsychological evaluation of adolescents with anorexia nervosa and of adolescents with conduct disorders. Journal of Adolescence 7, 245266.CrossRefGoogle ScholarPubMed
Hamsher, K, Halmi, K, Benton, A (1981). Prediction of outcome in anorexia nervosa from neuropsychological status. Psychiatry Research 4, 7988.CrossRefGoogle ScholarPubMed
Happé, F (1997). Central coherence and theory of mind in autism: reading homographs in context. British Journal of Developmental Psychology 15, 112.CrossRefGoogle Scholar
Happé, F, Booth, R (2008). The power of the positive: revisiting weak coherence in autism spectrum disorders. Quarterly Journal of Experimental Psychology 61, 5063.CrossRefGoogle ScholarPubMed
Happé, F, Briskman, J, Frith, U (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.CrossRefGoogle ScholarPubMed
Happé, F, Frith, U (2006). The weak coherence account: detail-focused cognitive style in autism spectrum disorders. Journal of Autism and Developmental Disorders 36, 525.CrossRefGoogle ScholarPubMed
Higgins, JPT, Thompson, SG, Deeks, JJ, Altman, DG (2003). Measuring inconsistency in meta-analyses. British Medical Journal 327, 557560.CrossRefGoogle ScholarPubMed
Holliday, J, Tchanturia, K, Landau, S, Collier, DA, Treasure, J (2005). Is impaired set-shifting an endophenotype of anorexia nervosa? American Journal of Psychiatry 162, 22692275.CrossRefGoogle ScholarPubMed
Horne, RL, Van Vactor, JC, Emerson, S (1991). Disturbed body image in patients with eating disorders. American Journal of Psychiatry 148, 211215.Google ScholarPubMed
Jolliffe, T, Baron-Cohen, S (1997). Are people with autism and Asperger syndrome faster than normal on the Embedded Figures Test? Journal of the American Academy of Child and Adolescent Psychiatry 38, 527534.Google ScholarPubMed
Jolliffe, T, Baron-Cohen, S (1999). A test of central coherence theory: linguistic processing in high-functioning adults with autism or Asperger syndrome: is local coherence impaired? Cognition 22, 149185.CrossRefGoogle Scholar
Kagan, J (1966). Reflection-impulsivity: the generality and dynamics of conceptual tempo. Journal of Abnormal Psychology 1, 1724.CrossRefGoogle Scholar
Kagan, J, Rosman, B, Day, D, Albert, J, Philips, W (1964). Information processing and the child: significance of analytic and reflective attitudes. Psychological Monographs 78, No. 578.CrossRefGoogle Scholar
Kaye, WH, Bastiani, AM, Moss, H (1995). Cognitive style of patients with anorexia nervosa and bulimia nervosa. International Journal of Eating Disorders 18, 287290.3.0.CO;2-Y>CrossRefGoogle ScholarPubMed
Key, A, O'Brien, A, Gordon, I, Christie, D, Lask, B (2006). Assessment of neurobiology in adults with anorexia nervosa. European Eating Disorders Review 14, 308314.CrossRefGoogle Scholar
Kingston, K, Szmukler, 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
Kitabayashi, Y, Ueda, H, Kashima, A, Okamoto, A, Kooguchi, Y, Narumoto, J, Wada, Y, Yamashita, T, Fukui, K (2004). Change of cognitive function following body weight recovery in anorexia nervosa. Seishin Igaku 46, 243248.Google Scholar
Lena, SM, Fiocco, AJ, Leyenaar, JK (2004). The role of cognitive deficits in the development of eating disorders. Neuropsychological Review 14, 99113.CrossRefGoogle ScholarPubMed
Lopez, C, Tchanturia, K, Stahl, D, Booth, R, Holliday, J, Treasure, J (2008 a). An examination of the concept of central coherence in women with anorexia nervosa. International Journal of Eating Disorders 41, 143152.CrossRefGoogle ScholarPubMed
Lopez, C, Tchanturia, K, Stahl, D, Treasure, J (2008 b). Central coherence in women with bulimia nervosa. International Journal of Eating Disorders 41, 340347.CrossRefGoogle ScholarPubMed
Mathias, J, Kent, P (1998). Neuropsychological consequences of extreme weight loss and dietary restriction in patients with anorexia nervosa. Journal of Clinical and Experimental Neuropsychology 20, 548564.CrossRefGoogle ScholarPubMed
McDowell, BD, Moser, DJ, Ferneyhough, K, Bowers, WA, Andersen, AE, Paulsen, JS (2003). Cognitive impairment in anorexia is not due to depressed mood. International Journal of Eating Disorders 33, 351355.CrossRefGoogle Scholar
McLaughlin, EF, Karp, SA, Herzog, DB (1985). Sense of ineffectiveness in woman with eating disorders: a clinical study of anorexia nervosa and bulimia. International Journal of Eating Disorders 4, 511523.3.0.CO;2-Z>CrossRefGoogle Scholar
Murphy, R, Nutzinger, DO, Paul, T, Leplow, B (2002). Dissociated conditional-associative learning in anorexia nervosa. Journal of Clinical and Experimental Neuropsychology 24, 176186.CrossRefGoogle ScholarPubMed
Murphy, R, Nutzinger, DO, Paul, T, Leplow, B (2004). Conditional-associative learning in eating disorders: a comparison with OCD. Journal of Clinical and Experimental Neuropsychology 26, 190199.CrossRefGoogle ScholarPubMed
Nakasuji, T (1999). Clinical and psychological characteristics in anorexia nervosa and bulimia nervosa. Journal of the Osaka City Medical Center 48, 153170.Google Scholar
Osterrieth, P (1944). The test of copying a complex figure: a contribution to the study of perception and memory. Archives de Psychologie 30, 206356.Google Scholar
Pendleton Jones, B, Duncan, C, Brouwers, P, Mirsky, A (1991). Cognition in eating disorders. Journal of Clinical and Experimental Neuropsychology 13, 711728.CrossRefGoogle Scholar
Ranseen, JD, Humphries, LL (1992). The intellectual functioning of eating disorder patients. Journal of the American Academy of Child and Adolescent Psychiatry 31, 844846.CrossRefGoogle ScholarPubMed
Riding, RJ, Pearson, F (1994). The relationship between cognitive style and intelligence. Educational Psychology 14, 413425.CrossRefGoogle Scholar
Roberts, ME, 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
Savage, CR, Baer, L, Keuthen, N, Brown, HD, Rauch, SL, Jenike, MA (1999). Organizational strategies mediate nonverbal memory impairment in obsessive-compulsive disorder. Biological Psychiatry 45, 905916.CrossRefGoogle ScholarPubMed
Schmidt, U, Treasure, J (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.CrossRefGoogle ScholarPubMed
Shah, A, Frith, U (1993). Why do autistic individuals show superior performance on the block design task? Journal of Child Psychology and Psychiatry 34, 13511364.CrossRefGoogle ScholarPubMed
Sherman, BJ, Savage, CR, Eddy, KT, Blais, MA, Deckersbach, T, Jackson, SC, Franko, DL, Rauch, SL, Herzog, DB (2006). Strategic memory in adults with anorexia nervosa: are there similarities to obsessive compulsive spectrum disorders? International Journal of Eating Disorders 39, 468476.CrossRefGoogle ScholarPubMed
Small, A, Madero, J, Teagno, L, Ebert, M (1983). Intellect, perceptual characteristics, and weight gain in anorexia nervosa. Journal of Clinical Psychology 39, 780782.3.0.CO;2-Q>CrossRefGoogle ScholarPubMed
Small, A, Teagno, L, Madero, J, Gross, H, Ebert, M (1982). A comparison of anorexics and schizophrenics on psychodiagnostic measures. International Journal of Eating Disorders 1, 4956.3.0.CO;2-O>CrossRefGoogle Scholar
Sours, JA (1969). The anorexia nervosa syndrome: phenomenologic and psychodynamic components. Clinical heterogeneity in four cases. Psychiatric Quarterly 43, 240256.CrossRefGoogle ScholarPubMed
Southgate, L, Tchanturia, K, Collier, D, Treasure, J (in press). The development of the Maudsley Childhood Obsessive–Compulsive Personality Trait Questionnaire in an eating disorder sample. European Eating Disorders Review.Google Scholar
Southgate, L, Tchanturia, K, Treasure, J (2007). Information processing bias in anorexia nervosa. Psychiatry Research. doi: 10.1016/j.psychres.2007.07.017.Google Scholar
Spreen, O, Strauss, E (1998). A Compendium of Neuropsychological Tests: Administration, Norms and Commentary. Oxford University Press: New York.Google Scholar
Steichen, T (1998). sbe19: tests for publication bias in meta-analysis. Stata Technical Bulletin 41, 915.Google Scholar
Steinglass, JE, Walsh, T, Stern, Y (2006). Set shifting deficit in anorexia nervosa. Journal of the International Neuropsychological Society 12, 431435.CrossRefGoogle ScholarPubMed
Strauss, E, Sherman, E, Spreen, O (2006). A Compendium of Neuropsychological Tests: Administration, Norms, and Commentary. Oxford University Press: Oxford.Google Scholar
Szmukler, GI, Andrewes, D, Kingston, K, Chen, L, Stargatt, R, Stanley, R (1992). Neuropsychological impairment in anorexia nervosa: before and after refeeding. Journal of Clinical and Experimental Neuropsychology 14, 347352.CrossRefGoogle ScholarPubMed
Talarczyk, M, Rajewski, A (2001). Self-acceptance level in patients with anorexia nervosa. Psychiatria Polska 35, 389398.Google ScholarPubMed
Tchanturia, K, Morris, R, Anderluh, M, Collier, D, Nikolaou, V, Treasure, J (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.CrossRefGoogle ScholarPubMed
Thompson, S (1993). Implications of neuropsychological test results of women in a new phase of anorexia nervosa. European Eating Disorders Review 1, 152165.CrossRefGoogle Scholar
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
Toner, BB, Garfinkel, PE, Garner, DM (1987). Cognitive style of patients with bulimic and diet-restricting anorexia nervosa. American Journal of Psychiatry 144, 510512.Google ScholarPubMed
Touyz, SW, Beumont, PJV, Johnstone, LC (1986). Neuropsychological correlates of dieting disorders. International Journal of Eating Disorders 5, 10251034.3.0.CO;2-T>CrossRefGoogle Scholar
Treasure, J (2007). Getting beneath the phenotype of anorexia nervosa: the search for viable endophenotypes and genotypes. Canadian Journal of Psychiatry 52, 212–209.CrossRefGoogle ScholarPubMed
Treasure, J, Lopez, C, Roberts, M (2007). Endophenotypes in eating disorders: moving toward etiologically based diagnosis and treatment focused on pathophysiology. Pediatric Health 1, 171181.CrossRefGoogle Scholar
Treasure, J, Southgate, L, Tchanturia, K, Lopez, C, Collier, D (2006). Gene environment and developmental issues in eating disorders. Association for Child and Adolescent Mental Health (ACAMH) Occasional Paper 25, 5162.Google Scholar
Wechsler, D (1949). Wechsler Intelligence Scale for Children (WISC). The Psychological Corporation: San Antonio, TX.Google Scholar
Wechsler, D (1974). Wechsler Intelligence Scale for Children – Revised (WISC-R). The Psychological Corporation: San Antonio, TX.Google Scholar
Wechsler, D (1981). Wechsler Adult Intelligence Scale – Revised (WAIS-R). The Psychological Corporation: San Antonio, TX.Google Scholar
Wentz, E, Gillberg, C, Gillberg, IC, Rastam, M (1999). Ten-year follow-up of adolescent-onset anorexia nervosa: personality disorders. Journal of the American Academy of Child and Adolescent Psychiatry 38, 13891395.Google Scholar
Wilson, DB (2001). Effect Size Determination Program. University of Maryland: College Park, MD.Google Scholar
Witkin, H, Oltman, P, Raskin, E, Karp, S (1971). A Manual for the Embedded Figures Test. Consulting Psychologists Press: Palo Alto, CA.Google Scholar
Witkin, H, Oltman, P, Raskin, E, Karp, S (2002). Group Embedded Figures Test Manual. Mind Garden, Inc.: Redwood City, CA.Google Scholar