The Role of Self-Control in Anorexia Nervosa

Abstract

Self-control, a key cognitive ability, facilitates the adjustment of behaviour to meet societal norms by overriding thoughts and emotions. Abnormal self-control can be detrimental, particularly in the context of Anorexia Nervosa (AN). AN is a disorder marked by extreme self-control, particularly in dietary intake, potentially leading to deficits in emotional regulation and cognitive abilities. The fear of weight gain can heighten anxiety levels, leading to more restrictive diets and potential comorbidity with other disorders when weight satisfaction is not achieved. However, the exact mechanism between self-control and AN is unclear. Therefore, this review aims to enhance understanding of AN and the role of self-control in its development and management from three perspectives: the cognitive aspects of self-control in AN, factors of social and emotion in AN and self-self, and effective interventions for AN. Through this examination, this review aims to deepen peoples understanding of AN and the role of self-control in its manifestation and management. This review investigates the multifaceted interplay between AN, self-control, emotional regulation, and cognitive rigidity, characterized by restrictive dietary practices and exceedingly low body weights, and presented in two distinct subtypes: restricting and binge-eating/purging. AN individuals exhibit high self-regulation but are prone to negative affective states, underscoring the complexity of emotional regulation in this disorder. A comparison with Bulimia Nervosa illuminates that enhancing self-control can have divergent effects: potentially reducing restrictive eating in AN, while escalating excessive eating in Bulimia Nervosa. The review also highlights the escalated social-cognitive sensitivity and cognitive rigidity in AN individuals, which often trigger restrictive eating. Further, it points to the low mentalizing abilities and high alexithymia levels in AN individuals, leading to cognitive and behavioural inflexibility. Finally, it proposes that neuro-modulatory interventions, such as transcranial magnetic stimulation, may enhance cognitive flexibility in food choices, providing a novel perspective on AN treatment. This review can provide some guidance for prevention and intervention progroms in high schools and colleges.