Cognitive Rigidity Found in Women with Anorexia

Cognitive flexibility is an important trait and is used in decision making, task switching, and processing of information. In psychological research, cognitive inflexibility has been identified as a potential risk factor or result of various mental health conditions. With regard to eating and food issues, cognitive rigidity has been present in people with anorexia nervosa (AN). Although the research into cognitive flexibility and AN has provided inconsistent results, it is theorized that this rigidity could be involved in the distorted body image and self-perceptions that people with AN often have.

To look into this issue further, Yasuhiro Sato of the Department of Psychosomatic Medicine at Tohoku University Hospital in Japan recently led a small study involving 15 young women with AN and 15 without. The women were assessed for AN, but were not categorized based on caloric restrictive anorexia nervosa (ANR) or AN with binging and purging (ANBP). The participants underwent magnetic resonance imaging (MRI) scans as they completed a decision making task.

Sato discovered that the women with AN performed far worse on the task than the control participants. The MRIs showed that brain activity in the right prefrontal cortex and bilateral hippocampal cortex was diminished during the shifting exercise in the women with AN. The control participants demonstrated a positive association between the same brain regions and correct shifting responses.

The results of this research suggest that women with AN may have a neurological deficit that contributes to distorted body image. Sato also looked at body mass index (BMI) to see if weight had any impact on the neurological findings, but found that BMI was not linked at all to task performance or shifting ability. Sato said, “These results suggest that impaired cognitive flexibility in AN patients is not a state due to starvation but is a trait of the disease,” and hoped that these findings are extended in future research that addresses the limitations in this study. In particular, future work should use a larger sample size and should aim to identify any neurological differences in women with ANR and those with ANBP.

Sato, Y., Saito, N., Utsumi, A., Aizawa, E., Shoji, T., et al. (2013). Neural Basis of Impaired Cognitive Flexibility in Patients with Anorexia Nervosa. PLoS ONE 8(5): e61108. doi:10.1371/journal.pone.0061108

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  • Marianne

    May 21st, 2013 at 1:27 PM

    I was thinking while reading this that maybe this sort of rigid thought process is one of the very reasons why so many men and women with An still can look at themselves when they are at their sickest and still feel like they are fat and grotesque. It is like their mind doesn’t have that switch to let them change how they see themselves even when the rest of us see them as being completely bony and skeletal.

  • fran w

    May 22nd, 2013 at 3:59 AM

    Hopefully eating disorder centers and counselors who work with this demographic are paying attention to these findings.

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