Tchanturia K, Morris R G, Anderluh M Brecelj, Collier D A, Nikolaou V, Treasure J
Eating Disorders Research Unit, Institute of Psychiatry, King's College London, De Crespigny Park, London SE5 8AF, UK.
J Psychiatr Res. 2004 Sep-Oct;38(5):545-52. doi: 10.1016/j.jpsychires.2004.03.001.
Deficits in set shifting tasks are present in anorexia nervosa (AN), but it is not known whether these deficits are traits independent of current disease or nutritional status or merely a temporary consequence of starvation or psychopathology. The aims of the present study were to determine if set-shifting sub-optimal performance are state or trait-related by examining set shifting in patients with current or past AN, and the extent of association of these deficits with obsessive compulsive traits and behaviours. To achieve this we examined set shifting abilities in three groups of subjects: (a) AN patients with current illness, prior to receiving treatment (AN); (b) people with past AN currently in long term recovery (ANRec) and a healthy comparison group (HC). We also longitudinally followed up a subset for the AN group who showed weight recovery in response to in patient treatment (ANWR). We administered a group of set shifting tests, which included cognitive, perceptual and motor shifting tasks. A semi-structured interview was obtained to ascertain obsessive compulsive personality disorder (OCPD) traits as a child and adult. Set-shifting difficulties were observed in the AN group, but to a lesser extent in the ANRec group. In the AN group these difficulties did not show any improvement follow re-testing after weight recovery. Performance on set shifting tasks was associated with childhood rigidity and inflexibility. Some aspects of set shifting sub-optimal performance in AN appear to be a trait rather than a state marker.
神经性厌食症（AN）患者存在转换任务缺陷，但尚不清楚这些缺陷是独立于当前疾病或营养状况的特质，还是仅仅是饥饿或精神病理学的暂时后果。本研究的目的是通过检查当前或既往患有AN的患者的转换任务，来确定转换任务的次优表现是与状态相关还是与特质相关，以及这些缺陷与强迫性特质和行为的关联程度。为了实现这一目标，我们检查了三组受试者的转换能力：（a）当前患病且未接受治疗的AN患者（AN组）；（b）既往患有AN且目前处于长期康复期的人（ANRec组）和健康对照组（HC组）。我们还对AN组中因住院治疗而体重恢复的一部分患者（ANWR组）进行了纵向随访。我们进行了一组转换测试，包括认知、感知和运动转换任务。通过半结构化访谈确定儿童期和成年期的强迫型人格障碍（OCPD）特质。在AN组中观察到转换困难，但在ANRec组中程度较轻。在AN组中，体重恢复后再次测试时，这些困难并未有任何改善。转换任务的表现与儿童期的刻板和僵化有关。AN中转换任务次优表现的某些方面似乎是一种特质而非状态标记。
