School of Psychology, Deakin University, Geelong, Australia.
Institute for Health and Sport, Victoria University, Melbourne, VIC, Australia.
BMC Psychiatry. 2024 Jun 18;24(1):454. doi: 10.1186/s12888-024-05837-6.
Difficulties with inhibitory control have been identified in eating disorders (EDs) and neurodevelopmental disorders (NDs; including attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder), and there appear to be parallels between the expression of these impairments. It is theorised that impairments in inhibitory control within NDs may represent a unique vulnerability for eating disorders (EDs), and this same mechanism may contribute to poorer treatment outcomes. This review seeks to determine the state of the literature concerning the role of inhibitory control in the overlap of EDs and neurodivergence.
A scoping review was conducted to summarise extant research, and to identify gaps in the existing knowledge base. Scopus, Medline, PsycInfo, Embase, and ProQuest were systematically searched. Studies were included if the study measured traits of ADHD or autism, and symptoms of ED, and required participants to complete a performance task measure of inhibitory control. Where studies included a cohort with both an ND and ED, these results had to be reported separately from cohorts with a singular diagnosis. Studies were required to be published in English, within the last 10 years.
No studies explored the relationship between autism and EDs using behavioural measures of inhibitory control. Four studies exploring the relationship between ADHD and EDs using behavioural measures of inhibitory control met selection criteria. These studies showed a multifaceted relationship between these conditions, with differences emerging between domains of inhibitory control. ADHD symptoms predicted poorer performance on measures of response inhibition in a non-clinical sample; this was not replicated in clinical samples, nor was there a significant association with EDs. Both ADHD and ED symptoms are associated with poor performance on attentional control measures; where these diagnoses were combined, performance was worse than for those with a singular diagnosis of ADHD. This was not replicated when compared to those with only ED diagnoses.
Impairments in attentional control may represent a unique vulnerability for the development of an ED and contribute to poor treatment outcomes. Further research is needed to explore the role of inhibitory control in EDs, ADHD and autism, including the use of both self-report and behavioural measures to capture the domains of inhibitory control.
在饮食障碍（EDs）和神经发育障碍（NDs；包括注意力缺陷多动障碍（ADHD）和自闭症谱系障碍）中，已经发现了抑制控制方面的困难，并且这些障碍的表现之间似乎存在相似之处。有人认为，NDs 中抑制控制方面的缺陷可能代表了饮食障碍（EDs）的独特易感性，而同样的机制可能会导致治疗效果较差。本综述旨在确定有关抑制控制在 EDs 和神经多样性重叠中的作用的文献状况。
进行了范围界定综述，以总结现有研究，并确定现有知识库中的空白。系统地搜索了 Scopus、Medline、PsycInfo、Embase 和 ProQuest。如果研究测量了 ADHD 或自闭症的特征以及 ED 的症状，并且要求参与者完成抑制控制的行为任务测量，则纳入研究。如果研究包括一个既有 ND 又有 ED 的队列，则必须将这些结果与仅有单一诊断的队列分开报告。研究必须以英文发表，且在过去 10 年内。
没有研究使用抑制控制的行为测量来探索自闭症与 EDs 之间的关系。四项使用抑制控制的行为测量来探索 ADHD 与 EDs 之间关系的研究符合选择标准。这些研究表明，这些病症之间存在多方面的关系，并且在抑制控制的不同领域存在差异。在非临床样本中，ADHD 症状预测了反应抑制测量中的较差表现；但在临床样本中未得到复制，也与 EDs 没有显著关联。ADHD 和 ED 症状均与注意力控制测量中的较差表现相关；当这些诊断合并时，表现比仅有 ADHD 单一诊断的情况更差。但与仅有 ED 诊断的情况相比，并未得到复制。
注意力控制方面的缺陷可能代表了 ED 发展的独特易感性，并导致治疗效果不佳。需要进一步研究来探索抑制控制在 EDs、ADHD 和自闭症中的作用，包括使用自我报告和行为测量来捕捉抑制控制的各个领域。
