McConnellogue, DM; (2012) Set shifting, central coherence and starvation in eating disorders. Doctoral thesis , UCL (University College London).

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Abstract

Aims: This review aims to evaluate and synthesise previous research on set shifting in eating disorders in order to determine whether individuals with eating disorders have impaired set shifting. It also aims to determine whether set shifting difficulties are a risk factor for eating disorders or a consequence of starvation. Method: A summary and critique of the 13 papers specifically exploring set shifting in eating disorders is presented and followed by a synthesis of the results. Results: There is evidence for set shifting difficulties in Anorexia Nervosa (AN) and Bulimia Nervosa (BN) however no research has been conducted into Binge Eating Disorder (BED). This review suggests that starvation may have a mediating or maintaining role in neuropsychological impairments, rather than causing them per se. Increased set shifting impairments in recovered AN participants and genetic relatives suggest that set shifting difficulties may be a predisposing trait, increasing vulnerability to eating disorders. However, there are various methodological limitations (such as no power analyses to estimate required sample sizes) which are discussed and should be kept in mind. Conclusions: Although there is evidence for set shifting difficulties in AN and BN, the evidence is still very mixed and there is a need for use of consistent measures and clear reporting of findings with equal importance given to non-significant results.

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