Neuropsychological assessment in children and adolescent patients with anorexia nervosa: Exploration and identification of distinct neuropsychological strengths and weaknesses

Abstract

Investigation of the neuropsychological functions associated with anorexia nervosa (AN) may help to better understand this disorder. This thesis aims to explore neuropsychological functioning in children and adolescents with AN using a profiling framework utilising qualitative, case control and cross-sectional designs to identify distinct profiles and their association with clinical characteristics. In addition, a) visuo-processing skills operationalised as central coherence, organisational strategy and visuo-spatial memory and b) planning ability were investigated using case-control design. Paper 1 reviews neuroscience-based conceptual models of eating disorders which identified a critical volume of empirical studies that allowed integration of theories to preliminarily model relationships between constructs spanning genomics to self-report. Paper 2 describes how neuroscientists and clinicians developed a neuropsychological battery aimed at overcoming identified challenges within the field of AN. Papers 3 and 4 reveal a range of different neuropsychological profiles in children and adolescents with AN rather than one characteristic profile. Paper 5 finds no significant differences between healthy controls and patients with AN in central coherence, organisational strategy and visuo-spatial memory recall, although patients performed significantly better on copy accuracy and took significantly longer to copy. Paper 6 reveals there are no significant deficits in planning found in young people with AN. There is evidence of subtle differences in learning style and strategy between those with AN and healthy controls. Findings and their implications for the field of AN are further explored: Developmental trajectory, effects of starvation on neuropsychological functioning, early vs. later AN onset, cognitive remediation therapy as a treatment for AN and future research.