Sfärlea Anca, Lukas Linda, Schulte-Körne Gerd, Platt Belinda
Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, Ludwig-Maximilians-University Munich, Pettenkoferstr. 8a, 80336, Munich, Germany.
J Eat Disord. 2021 Oct 29;9(1):139. doi: 10.1186/s40337-021-00494-6.
Anorexia nervosa (AN) is characterized by dysfunctional cognitions including cognitive biases at various levels of information processing. However, less is known about the specificity of these biases, i.e., if they occur for eating-disorder-related information alone or also for non-eating-disorder-related emotional information in AN patients (content-specificity) and if they are unique to individuals with AN or are also shown by individuals with other mental disorders (disorder-specificity).
The present study systematically assesses cognitive biases in 12-18-year-old female adolescents with AN on three levels of information processing (attention, interpretation, and memory) and with regard to two types of information content (eating-disorder-related, i.e., stimuli related to body weight and shape, and non-eating-disorder-related). To address not only content- but also disorder-specificity, adolescents with AN will be compared not only to a healthy control group but also to a clinical control group (adolescents with major depression or particular anxiety disorders). Cognitive biases are assessed within a single experimental paradigm based on the Scrambled Sentences Task. During the task eye movements are recorded in order to assess attention biases while interpretation biases are derived from the behavioural outcome. An incidental free recall test afterwards assesses memory biases. We expect adolescents with AN to show more pronounced negative cognitive biases on all three levels of information processing and for both types of content compared to healthy adolescents. In addition, we expect the specificity of biases to translate into differential results for the two types of content: AN patients are expected to show stronger biases for disorder-related stimuli but similar or less pronounced biases for non-disorder-related stimuli compared to the clinical control group.
This is the first study to comprehensively assess cognitive biases in adolescents with AN. It will have essential implications not only for cognitive-behavioural models of AN but also for subsequent studies aiming to modify cognitive biases in this population, thereby addressing important maintaining factors already at an early stage of the disorder.
神经性厌食症（AN）的特征是认知功能失调，包括在信息处理的各个层面存在认知偏差。然而，对于这些偏差的特异性，即它们是否仅在与饮食失调相关的信息中出现，还是也会在AN患者的非饮食失调相关的情绪信息中出现（内容特异性），以及它们是AN患者所独有的，还是其他精神障碍患者也会表现出来（疾病特异性），我们了解得较少。
本研究系统评估了12至18岁患AN的女性青少年在信息处理的三个层面（注意力、解释和记忆）以及两种信息内容类型（与饮食失调相关的，即与体重和体型相关的刺激，以及与饮食失调无关的）上的认知偏差。为了不仅解决内容特异性，还解决疾病特异性问题，患AN的青少年不仅将与健康对照组进行比较，还将与临床对照组（患有重度抑郁症或特定焦虑症的青少年）进行比较。认知偏差是在基于乱序句子任务的单一实验范式中进行评估的。在任务过程中记录眼动，以评估注意力偏差，而解释偏差则从行为结果中得出。随后的附带自由回忆测试评估记忆偏差。我们预计，与健康青少年相比，患AN的青少年在信息处理的所有三个层面以及两种内容类型上都会表现出更明显的负面认知偏差。此外，我们预计偏差的特异性会转化为两种内容类型的不同结果：与临床对照组相比，预计AN患者对与疾病相关的刺激表现出更强的偏差，但对与非疾病相关的刺激表现出相似或不太明显的偏差。
这是第一项全面评估患AN青少年认知偏差的研究。它不仅对AN的认知行为模型具有重要意义，而且对旨在改变该人群认知偏差的后续研究也具有重要意义，从而在疾病的早期阶段就解决重要的维持因素。
