Set shifting in children and adolescents with anorexia nervosa: An exploratory systematic review and meta-analysis
Article first published online: 18 DEC 2013
Copyright © 2013 Wiley Periodicals, Inc.
International Journal of Eating Disorders
Volume 47, Issue 4, pages 394–399, May 2014
How to Cite
Lang, K., Stahl, D., Espie, J., Treasure, J. and Tchanturia, K. (2014), Set shifting in children and adolescents with anorexia nervosa: An exploratory systematic review and meta-analysis. Int. J. Eat. Disord., 47: 394–399. doi: 10.1002/eat.22235
- Issue published online: 11 APR 2014
- Article first published online: 18 DEC 2013
- Manuscript Accepted: 21 NOV 2013
- Manuscript Revised: 19 NOV 2013
- Manuscript Received: 14 JUL 2013
- National Institute for Health Research (NIHR) [Mental Health Biomedical Research Centre and/or Dementia Biomedical Research Unit] at South London; Maudsley NHS Foundation Trust and King's College London, Institute of Psychiatry and Swiss Anorexia Foundation
- anorexia nervosa;
- cognitive flexibility;
- thinking style;
- executive function
Set shifting inefficiencies in adults with anorexia nervosa (AN) are established, however the neurocognitive profile of children and adolescents with AN is less clear. This study aimed to provide a review of the literature.
Electronic databases were used to search for manuscripts.
Meta-analysis was performed on seven studies using two neuropsychological tests (Trail Making Task, TMT; Wisconsin Card Sorting Task, WCST). The mean difference in outcome between AN and healthy control (HC) groups was standardized by calculating Cohen's d. Meta-analysis of TMT studies showed a nonsignificant negative, pooled standardized mean difference of −0.005 (95% C.I. −0.416 to 0.406, z = 0.02, p = .98). WCST studies revealed a nonsignificant pooled effect size of d = 0.196 (95% C.I. −0.091–0.483, z = 1.34, p = .18). Studies which did not allow for a calculation of effect size typically showed a nonsignificant, worse performance by the AN groups.
The inefficiencies in set shifting that are apparent in the adult AN literature do not appear to be as pronounced in children. This may suggest that set shifting difficulties in adult AN are the result of starvation or indicative of longer duration of illness. Larger studies are needed to confirm these impressions. © 2013 Wiley Periodicals, Inc. (Int J Eat Disord 2014; 47:394–399)