Examination of cognitive flexibility and emotion recognition in patients with eating disorders

Objective: The primary aim of our study is to evaluate cognitive flexibility and emotion recognition in adolescent eating disorder (ED) patients by comparing them with the healthy control group. Another aim is to examine the relationship between cognitive flexibility and emotion recognition. Method: Forty-six patients who aged 12-18 years, diagnosed with Anorexia Nervosa (AN), Bulimia Nervosa (BN) or Binge Eating Disorder (BED), who applied to Ankara University Faculty of Medicine, Adult and Child and Adolescent Psychiatry Department Polyclinics and agreed to participate in the study, participated in our study. Forty healthy individuals matched with the patients in terms of age and years of education were included. Diagnosis of the participants was made with the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL) and a sociodemographic data form was filled in for each patient. The Cognitive Flexibility Scale (CFS) was filled in by the participants, and the test of perception of affect via Non-Verbal Cues (TPANC) was applied through the computer program. The Stroop Test and Berg Card Sorting Test (BCST) were administered via a computer program to assess cognitive flexibility. Results: ED patients had lower CFS scores than the control group. The group with the highest CFS score was the BED group, while the BN lowest scores were belonging to the BN group. When neuropsychological tests are evaluated; BCST perseverative error percentages were not different between ED patients and control group. But Stroop Interference effect in BED group was higher than both controls and the other two eating disorder groups. Emotion recognition scores of the ED group and the control group were not different. However, when the eating disorder subgroups were compared with controls; AN group achieved higher scores in the sub-domains of emotion recognition from voice tones and social stories. A negative correlation was found between emotion recognition performance and difficulty in set shifting in the ED group; however, this relationship was not seen between response inhibition and emotion recognition. There was no relationship between emotion recognition and cognitive flexibility in the healthy control group. Conclusions: It was found that, ED patients defined themselves to be more rigid in cognitive flexibility,but neuropsychological tests showed no difference in set shifting 4 compared to healthy controls. Only the BED group had greater difficulty in response inhibition. This situation seems different from the neurocognitive profile drawn by adult ED patients in the literature. Contrary to expectations, the ED group did not have emotion recognition difficulties, and the AN group recognized the feeling of disgust and fear better. These results suggest that emotion recognition difficulties and cognitive rigidity may not be a core construct for ED. In the light of all this information, further studies on this subject are needed.