Obsessive-compulsive Symptomatology Research Articles

Guilt and Shame in Patients with Obsessive-Compulsive Disorders

Introduction: Obsessive-compulsive disorder (OCD) is a tremendous psychiatric illness with a variety of severe symptoms. Feelings of shame and guilt are universal social emotions that fundamentally shape the way people interact with each other. Mental illness is therefore often related to pronounced feelings of shame and guilt in a maladaptive form. Methods: A total of 62 participants (38 women and 24 men) were clinically and psychometrically investigated. Results: The OCD patients (n = 31) showed a maladaptive guilt and shame profile, characterized by increased interpersonal feelings of guilt accompanied by a stronger tendency to self-criticism and increased punitive sense of guilt with a simultaneous prevailing tendency to perfectionism, as well as an increased concern for the suffering of others. The proneness to profuse shame in OCD patients seems to be in the context of the violation of inner values and a negative self-image with persistent self-criticism. Conclusion: Although there are limitations with a small sample size in this monocentric approach, our study underlines the importance of an individual consideration of the leading obsessive-compulsive symptomatology, especially in the context of very personal feelings of guilt and shame. Further multidimensional studies on guilt and shame could contribute to their implementation more strongly in individualized psychotherapy.

Dimensionality of scrupulosity and its associations with obsessive-compulsive symptomatology in a nonclinical sample: A network approach.

Dimensionality of scrupulosity and its associations with obsessive-compulsive symptomatology in a nonclinical sample: A network approach.

Supplemental Material for Dimensionality of Scrupulosity and Its Associations With Obsessive-Compulsive Symptomatology in a Nonclinical Sample: A Network Approach

Supplemental Material for Dimensionality of Scrupulosity and Its Associations With Obsessive-Compulsive Symptomatology in a Nonclinical Sample: A Network Approach

Greek adaptation of the Teruel Orthorexia Scale (TOS) in adults from the Republic of Cyprus: A bidimensional model may not be universal

The Teruel Orthorexia Scale (TOS) is a 17-item instrument designed to assess distinct facets of Orthorexia Nervosa (ON) and Healthy Orthorexia (HO). While a bidimensional model of TOS scores has been supported in diverse national and linguistic groups, the psychometric properties of the TOS have not been previously assessed in Greek-speaking populations. To rectify this, we assessed the psychometric properties of a novel Greek translation of the TOS in a sample of adults from Cyprus. A total of 1248 respondents (710 women, 538 men) completed the Greek TOS, as well as previously validated measures of perfectionism, obsessive-compulsive symptomatology, eating restriction, negative affect, and appearance evaluation. Our results showed that a bidimensional model of the TOS had less-than-adequate fit when modelled using both confirmatory factor analysis and exploratory structural equation modeling (ESEM). Conversely, both exploratory factor analysis and ESEM supported extraction of a 3-factor model consisting of a HO facet and separate components of emotional orthorexia and cognitive-social orthorexia. This 3-factor model showed a lack of measurement bias (measurement invariance across gender identity and lack of differential item functioning as function of age and body mass index), but there were differences in latent factor means as function of respondent age and body mass index. The 3-factor model showed adequate evidence of construct validity, with the latent emotional orthorexia and cognitive-social orthorexia facets showing significant and moderate associations with the additional constructs measured in the survey. Broadly speaking, these findings support the psychometric properties of a 3-factor model of the Greek TOS, but also suggest that the bidimensional model of the TOS may not have universal applicability. We encourage further assessments of factorial validity in other national and linguistic contexts.

A 12-Month Follow-Up of PROCARE+,a Transdiagnostic,Selective, Preventive Intervention for Adolescents At-Risk for Emotional Disorders.

Few studies have reported long-term follow-up data on selective preventive interventions for adolescents. No follow-up selective preventive transdiagnostic studies for adolescents at-risk for emotional disorders, such as anxiety and depression, have been reported. To fill this gap, this study aims to provide the first follow-up assessment of a randomized controlled trial (RCT) studying selective transdiagnostic prevention in at-risk adolescents. A 12-month follow-up assessment was conducted with subjects who originally received either PROCARE (Preventive transdiagnostic intervention for Adolescents at Risk for Emotional disorders), PROCARE+, which includes the PROCARE protocol along with personalized add-on modules or an active control condition (ACC) based on emotional psychoeducation, and their respective booster session for each experimental condition. 80 subjects (47.5% girls) aged between 12 and 18years (M = 14.62; SD 1.43) who completed these treatment conditions were available for the 12-month follow-up. The results demonstrate the superior long-termefficacy of the PROCARE+ intervention in mitigating emotional symptoms and obsessive-compulsive symptomatology compared to the PROCARE and ACC conditions, with effect sizes notably exceeding those commonly observed in preventive programs. While the three treatments demonstrated beneficial impacts, the pronounced results associated with PROCARE+ at the 12-month follow-up emphasized the importance of personalized treatment modules and the sustained benefits of booster sessions in the realm of preventive psychological interventions. The findings also highlight the potential role of add-on modules in enhancing the effects of the PROCARE+ condition.

Socioeconomic resources moderate the relationship between maternal prenatal obsessive-compulsive symptoms and infant negative affectivity

Perinatal maternal depression, anxiety, and stress are associated with poor infant outcomes. However, no known study has investigated the effects of perinatal maternal obsessive-compulsive symptomatology on infant outcomes while considering important situational factors such as socioeconomic resources. Therefore, we investigated the effects of prenatal and postnatal obsessive-compulsive symptomatology on infant behavioral reactivity, beyond the effects of postnatal depressive symptomatology, at 6 months of age. It was expected that socioeconomic resources would moderate this relationship. We recruited 125 pregnant women from a Health Professional Shortage Area for mental health and primary care in the Midwest United States and interviewed them at approximately 34 weeks gestation and again at 6 months postnatally. They were administered questionnaires at both time points measuring obsessive-compulsive and depressive symptoms. Infant behavioral reactivity was gathered during 6-month follow-up through behavioral observation coding and maternal-report modalities. Maternal-reported infant negative affectivity at 6 months was related to greater severity of maternal postnatal depressive symptomatology, and socioeconomic resources moderated the relationship between maternal prenatal obsessive-compulsive symptoms and maternal-reported infant negative affectivity. However, neither of these relations was statistically significant when infant reactivity was quantified using behavioral observations.

Mind-Wandering and Its Relationship With Psychological Wellbeing and Obsessive-Compulsive Symptomatology in the Context of Covid-19.

Mind-wandering (MW) as a research topic has received considerable attention over the last several decades. The recent differentiation between spontaneous and deliberate MW has suggested a particular effect of the former on psychopathology; in that increased spontaneous MW may precede mental illness. The present study sought to explore MW as a potential contributing factor to poor mental health in the context of the Covid-19 pandemic. More specifically, we sought to determine firstly, whether the effects of MW frequency, type and content on subjective psychological wellbeing was consistent with previous findings after controlling for the impacts of Covid-related stress. Secondly, previous research has demonstrated an effect of both Covid-stress and spontaneous MW on the experience of obsessive-compulsive symptomatology (OCS), and so the present study explored this relationship further by assessing whether Covid-stress mediated the relationship between spontaneous MW and OCS. Participants completed measures of MW, OCS and psychological wellbeing through an online questionnaire. The results indicated that increased spontaneous MW was indicative of both poorer subjective psychological wellbeing and OCS, with Covid-stress partially mediating the relationship between spontaneous MW and OCS. Our findings provide further support for the adverse effect of unintentional MW on psychological wellbeing, as well as for the differentiation between both forms of the cognitive phenomenon. Additionally, they provide an important insight into one of the factors that may have preceded poor mental health among the Irish population during Covid-19. Future research may build upon the present study by exploring similar relationships among clinical populations.

Psychopathological factors and personality dimensions on dysfunctional eating behaviors in a sample of individuals with obesity.

Obesity and eating disorders are considered to be part of a broad spectrum of disorders associated with weight issues and maladaptive eating styles. Several studies show that psychopathological and personality characteristics contribute to the development and maintenance of obesity and dysfunctional eating behaviors, showing a bidirectional relationship. The purpose of this study was to understand the role of psychopathological factors and personality dimensions on dysfunctional eating behaviors in a sample of individuals with obesity. The study was conducted with 96 individuals with obesity (31 males and 65 females) who underwent psychological assessment. The instruments administered included the Cognitive Behavioral Assessment 2.0 - Primary Scales, the Minnesota Multiphasic Personality Inventory-2, and the Eating Disorder Inventory. Relationships between dysfunctional eating behaviors and personality and psychopathological factors were explored through mediation analysis. Our results showed that difficulties related to impulse control and behavior, along with negative and dysphoric emotions, may be associated with difficulties in eating behavior. Mediation analysis showed that the combination of depressive and obsessive-compulsive symptomatology may exacerbate or contribute to the occurrence of eating disorders. These psychopathological aspects should be taken into account during the assessment of patients who decide to undergo bariatric surgery and should be targets of specific psychological interventions.

Relationship between Cognitive Strategies of Emotion Regulation and Dimensions of Obsessive-Compulsive Symptomatology in Adolescents.

Cognitive emotion regulation refers to the management of one's emotions through cognitive strategies. Studies have found that individuals with obsessive-compulsive symptoms utilize emotion regulation strategies differently compared to those without these symptoms. This study aims to investigate the relationship between cognitive strategies for emotion regulation and specific dimensions of obsessive-compulsive symptoms in adolescents. A cross-sectional descriptive study was conducted with 307 adolescents between 12 and 18 years old. Associations between sociodemographic variables, obsessive-compulsive symptoms, and emotion regulation strategies were examined using regression and network analyses. Regression results indicated that emotion regulation strategies and gender accounted for 28.2% of the variation in overall obsessive-compulsive symptoms (p < 0.001) and that emotion regulation explained most variance in the symptom dimension of obsessing. Network analysis showed that self-blame and catastrophizing were uniquely linked to overall obsessive-compulsive symptoms, while several strategies were uniquely linked to specific symptom dimensions. The adaptive strategy that demonstrated the strongest association with obsessive-compulsive symptoms was refocus on planning, while maladaptive strategies included catastrophizing, self-blame, and rumination. In conclusion, the results support the relationship between cognitive strategies for emotion regulation and dimensions of obsessive-compulsive symptoms in adolescents, though these relations appear complex and require further investigation. Addressing emotion regulation in the prevention of obsessive-compulsive symptoms may be warranted, but prospective studies are needed.

Orthorexic eating behaviors are not all pathological: a French validation of the Teruel Orthorexia Scale (TOS)

As no French validated measurement tool distinguishing healthy orthorexia (HeOr) from orthorexia nervosa (OrNe) currently exists, this study aimed at examining psychometric properties of the French version of the Teruel Orthorexia Scale (TOS). A sample of 799 participants (Mean [SD] age: 28.5 [12.1] years-old) completed the French versions of the TOS, the Düsseldorfer Orthorexia Skala, the Eating Disorder Examination-Questionnaire, and the Obsessive–Compulsive Inventory-Revised. Confirmatory factor analysis and exploratory structural equation modeling (ESEM) were used. Although the bidimensional model, with OrNe and HeOr, of the original 17-item version showed an adequate fit, we suggest excluding items 9 and 15. The bidimensional model for the shortened version provided a satisfactory fit (ESEM model: CFI = .963, TLI = .949, RMSEA = .068). The mean loading was .65 for HeOr and .70 for OrNe. The internal consistency of both dimensions was adequate (αHeOr = .83 and αOrNe = .81). Partial correlations showed that eating disorders and obsessive–compulsive symptomatology measures were positively related to OrNe and unrelated or negatively related to HeOr. The scores from the 15-item French version of the TOS in the current sample appears to present an adequate internal consistency, pattern of associations in line with what was theoretically expected, and promising for differentiating both types of orthorexia in a French population. We discuss why both dimensions of orthorexia should be considered in this area of research.

Comorbidity of Obsessive-Compulsive Symptomatology and Bowel and Bladder Dysfunction in a Tertiary Children's Hospital: A Case Series

ObjectiveTo improve understanding of co-occurring obsessive-compulsive disorder (OCD) and bowel and bladder dysfunction (BBD) in an outpatient pediatric urology clinic setting. To provide a series of clinical care recommendations to enhance the identification and integrated medical and behavioral health treatment of these disorders. MethodsAuthors participated in a series of discussions to define the patient population and specific aims for the study. Efforts were made to select index patients of diverse background despite limited sample availability. Three patients were ultimately selected for the study. ResultsThe case studies highlight the connection between urinary issues and underlying OCD symptoms. All patients were initially seen for medical treatment of urological symptoms, then referred for psychological evaluation, and were diagnosed with and received treatment for OCD. Similarities among the cases, including experience of phantom urinary incontinence, stressors present that contributed to symptoms, and obsessive fears of incontinence that led to compulsive behavior, were discussed. Differences between the cases, including patient age, sex, and compulsive behavior demonstrated (ie, urinary frequency, excessive wiping) were also reviewed. ConclusionAccess to a behavioral health provider can enhance the identification of comorbid psychological disorders and can reduce duration of symptoms through appropriate psychological treatment. Authors provide recommendations for screening measures and reinforce importance of including basic education on psychiatric diagnoses and impact on urological symptoms in urology and pediatric fellowship training programs. Future research exploring prevalence of comorbid psychiatric conditions and efficacy of treatment interventions in a pediatric urology population would be beneficial.

Obsessive-Compulsive Symptomatology and Disgust Propensity in Disordered Eating Behaviors of Adolescents with Celiac Disease.

Considering the importance of underlying psychopathological mechanisms that mediate maladaptive eating behaviors in celiac disease (CD) in the determination of cognitive-behavioral therapeutic approaches, we investigated the impact of obsessive-compulsive symptomatology and disgust propensity on disordered eating attitudes (DEA) and poor gluten-free diet (GFD) compliance in adolescents with CD. Adolescents with biopsy-proven CD (n = 148, aged 12-18years) were compared with age- and sex-matched controls (n = 104) in terms of eating attitudes/behaviors, obsessive-compulsive symptoms, and disgust propensity, as well as depression and anxiety to rule out depression- and anxiety-related covariates. The clinical implications associated with poor GFD compliance were determined using between-subgroup analysis. Multivariate linear regression and multiple logistic regression were used to identify predictors of DEA and GFD noncompliance, respectively. In adolescents with CD, DEA was remarkably associated with obsessive-compulsive symptom severity and disgust propensity, especially in contamination and core disgust sub-dimensions. Obsessionality and disgust propensity were independent predictors of DEA, of which the obsessive-compulsive symptom severity was the most decisive predictor of DEA. Higher DEA severity and lower body mass index were independent predictors of poor GFD compliance. Higher obsessionality, accompanied by disgust-related evaluative conditioning processes, may contribute to constructing a cognitive network consisting of hypervigilance and catastrophic interpretations towards benign somatic stimulations, food-related preoccupations, and avoidant behaviors in the disordered eating of adolescents with CD. The reciprocal relationship between lifelong GFD and DEA, mediated by obsessionality and disgust propensity, was supported by current findings that could guide clinicians in the management of maladaptive eating behaviors in adolescents with CD.

Not just right experiences and incompleteness as a predictor of Obsessive Compulsive symptoms in clinical and community samples: A meta-analysis

Sensory phenomena (SP) are uncomfortable feelings, including bodily sensations, “just-right” perceptions and feelings of incompleteness, which have been shown to be predictors of symptom severity in individuals with obsessive–compulsive disorder (OCD). These sensory phenomena have also been related to obsessive compulsive (OC) traits within the general population. This meta-analysis aimed to quantify a possible relationship between sensory phenomena (incompleteness and Not Just in Right Experiences; NJRE), with OC symptoms in clinical and non-clinical samples. Methods: A systematic search was conducted for studies in children and adult populations of patients with OCD and in general populations displaying symptoms of OCD. Results: Effect sizes of incompleteness and NJRE were correlated to OCD symptoms. The effects sizes in the clinical and non-clinical groups did not differ significantly. Discussion: Robust effect sizes of incompleteness and NJRE in relation to OC symptomatology confirm sensory phenomena as marker of OC symptoms in both groups. The findings suggest that sensory phenomena could be targeted as an intervention in those showing both clinical and sub-clinical levels of OC traits.

Changes in obsessive–compulsive symptoms during inpatient treatment of anorexia nervosa

BackgroundObsessive–compulsive disorder (OCD) is one of the most prevalent comorbidities in anorexia nervosa (AN). As AN is a severe, life-threatening condition, reducing obsessive–compulsive symptomatology is not the primary objective during treatment of AN and, thus, these symptoms may remain unchanged or may even increase in terms of a “symptom shift”.MethodsIn this retrospective analysis, we examined clinical records of 149 adolescents (n = 96, 64%) and adults (n = 53, 36%) with AN (6 males, 4%) who received inpatient treatment and completed the Obsessive–Compulsive Inventory–Revised at admission and discharge.ResultsObsessive–compulsive symptoms decreased from admission to discharge, irrespective of whether patients had comorbid OCD or not. Within-person decreases in obsessive–compulsive symptoms weakly correlated with increases in body weight.ConclusionsThese results indicate that obsessive–compulsive symptoms decrease during inpatient treatment of AN although they are not primarily targeted during treatment. Furthermore, these improvements seem to be associated with general improvements in AN symptomatology, suggesting the absence of a “symptom shift”. Yet, effect sizes were small and obsessive–compulsive symptoms were still clinically elevated in patients with comorbid OCD at discharge, suggesting that these patients need OCD-specific, psychotherapeutic aftercare.

Who guards over obsessive fear of guilt? The case of Not Just Right Experiences and disgust

• We examined NJREs and Disgust as mediators of guilt and obsessive compulsive symptoms. • Fear of guilt was related to obsessive compulsive symptomatology. • Guilt was a predictor of obsessive checking and obsessing symptomatology in people with high scores in NJREs. • Guilt and NJREs are related to ordering symptomatology. • Guilt was a predictor of washing symptomatology in people with high disgust proneness. Background Guilt emotion, responsibility, disgust and Not Just Right Experiences (NJREs) are currently considered pivotal ingredients of Obsessive–Compulsive Disorder (OCD). Significant associations have been found between these variables and Obsessive–Compulsive (OC) symptoms, both in non-clinical and clinical populations. The main objective of our study was to shed light, in a nonclinical sample, on the patterns of association between these different constructs hypothesized to underlie OC symptoms. Methods Ninety-six healthy participants filled out measures of NJREs, OC symptoms, fear of guilt, and proneness to experiencing disgust. Results showed that while fear of guilt is a significant predictor of the different symptom clusters of OCD, disgust and NJREs differently contribute to symptomatic manifestation. Specifically, these findings suggest that while fear of feeling guilty is a cross-sectional ingredient of symptomatology, disgust and/or NJREs may function as sentinels of guilt, resulting in different behavioral outcomes. Limitations The use of healthy participants and of a single measure for NJREs, guilt, and disgust could limit the generalizability of the results. Conclusions These results support the primary role of guilt in the phenomenology of OC symptoms and support the perspective arguing for the centrality of the role of guilt in OC symptoms.

Increases in symptoms associated with obsessive-compulsive disorder among university students during the COVID-19 pandemic

Objective The long-term consequences of the COVID-19 pandemic on college students’ mental health remains unknown. The current study explored self-reported Obsessive-Compulsive symptomatology among college student cohorts from pre-, peak-, and later-pandemic time points. Participants Undergraduate college students (N = 524) who volunteered for course credit. Methods Self-report responses on the Dimensional Obsessive-Compulsive Scale (DOCS), which includes subscales for contamination, unacceptable thoughts, harm responsibility, and symmetry, were collected from November 29, 2016 through April 27, 2021 and assessed for differences between the pre-, peak-, and later-pandemic cohorts. Results Peak-pandemic responders reported higher symptomatology for contamination and unacceptable thoughts compared to pre-pandemic responders (and for pre- vs. later-pandemic for contamination), with no significant effects for symmetry or harm responsibility. Conclusions Although the longer-term consequences of the COVID-19 pandemic on students remains unknown, a greater shift in college mental health services from prevention to assessing and addressing more immediate challenges may be necessary.

Effects of the COVID-19 pandemic on the prevalence of obsessive-compulsive symptoms among young adults in Peru

The COVID-19 pandemic has exposed the general population to constant stressful and traumatic situations. This, added to the necessary and constant dissemination of preventive measures for COVID-19 infection, can generate an increase in the prevalence of Obsessive-Compulsive (OC) symptoms. Thus, this research aimed to evaluate the prevalence of OC symptoms and explore associated factors in young adults in Peru, the country with the highest COVID-19 death rate in the world. In this analytical cross-sectional study, an online survey distributed through social networks was used. OC symptomatology during the last week was measured by the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). Possible Generalized Anxiety Disorder (GAD) and Major Depressive Disorder (MDD) were evaluated with the General Anxiety Disorder 7-items (GAD-7) and Patient Health Questionnaire-9 (PHQ-9), respectively. 1243 young adults were evaluated. Of these, the mean age was 24.1 years, 54.3% were women, and the prevalence of OC symptoms was 50%. Participants who had experienced a traumatic event during COVID-19 pandemic had higher prevalence of OC symptoms (PR 1.54; CI 95% 1.27 – 1.85), when compared to those did not experience such events. In the same way, participants diagnosed with depression (PR 2.37; CI 95% 1.96 – 2.86) and anxiety (PR 1.11; CI 95% 1.02 – 1.21) also had a higher prevalence of OC symptoms, compared with those without depression and anxiety. In conclusion, obsessive-compulsive symptomatology has a high prevalence in young adults, and is associated with the death of a family member or close friend from the COVID-19 disease. The prevalence of possible depression and anxiety are high and are associated with higher prevalence of obsessive-compulsive symptoms. This highlights the importance of including mental health programs during the pandemic for the population who has suffered traumatic events, to be able to give them adequate follow-up and support.

Explanatory Psychological Models of Obsessive Functioning: Systematic Review of Mancini’s Cognitive Model and Theoretical Review of Young’s Maladaptive Cognitive Schemas Model

Obsessive-compulsive disorder is one of the most common, debilitating, and expensive illnesses for the medical systems focusing on mental health. Given the heterogeneity specific to obsessive-compulsive symptomatology, experts have proposed several explanatory models over time to point out the mechanisms leading to such pathology. This research study – organised into two parts – analyses existing empirical data regarding two explanatory cognitive models of obsessive functioning, namely Mancini’s cognitive model and Young’s schemas and dysfunctional modes model. The first part comprises three systematic reviews with three qualitative analyses and a meta-analysis regarding the three main hypotheses of Mancini’s model. The meta-analyses have shown an average-sized effect of deontological guilt in the emergence of OCD-like behaviours in the non-clinical population compared to inducing altruistic guilt. However, the qualitative analyses suggest evidence regarding the association between disgust, Not Just Right Experience (NJRE) and OCD symptomatology. The second part of the research comprises a theoretical review of the studies focusing on Young’s schema therapy mode model to explain obsessive mental functioning. The present research studies on the topics are scarce, but they suggest that the two cognitive models point out accurately the mechanisms of obsessive functioning. Findings also show that there are attempts to reunite the two models in a more complex explanatory model. The aspects above may lead to the development of more effective intervention protocols for this type of pathology.

Picky Eating in Childhood: Associations With Obsessive-Compulsive Symptoms.

To test whether childhood picky eating (PE)-a behavior previously linked to many forms of psychopathology-is specifically associated with symptoms of obsessive-compulsive disorder (OCD). We investigated the relationship between PE and symptoms of several forms of psychopathology in two separate observational samples: a sample of 110 children (5 and 6 years old) and a sample of 210 children (8 and 9 years old) drawn from a longitudinal study. In each sample, regression models based on psychiatric symptoms or diagnoses were used to assess the specificity of PE associations while accounting for cooccurring symptoms or comorbidities. Although bivariate associations emerged between PE and multiple forms of psychopathology, multivariate analyses revealed these associations were driven by a strong and specific association between PE and symptoms of OCD in both samples. Moreover, PE among 8- and 9-year-olds in the longitudinal study predicted emergence of additional later psychopathology, specifically attention-deficit/hyperactivity disorder (ADHD). Findings suggest that PE, an easily identifiable clinical presentation, is also a specific marker for obsessive-compulsive symptomatology in school-age children and may impart risk for ADHD later in childhood.

Cognitive flexibility and attention to detail in adolescents and adults with severe forms of anorexia nervosa.

To determine if adolescents and adults diagnosed with anorexia nervosa differ in their levels of cognitive flexibility and attention to detail independently of potential confounds. Sixty-two adolescents and 54 adults were assessed while receiving inpatient treatment and completed the following self-reports: Eating Disorders Examination Questionnaire, Maudsley Obsessive Compulsive Inventory and Hospital Anxiety and Depression scale. Performance-based evaluations included the Wisconsin Card Sorting Test Computerised Version, the Comprehensive Trail Making Test, the Brixton Spatial Anticipation Test, the Rey Complex Figure and the Group Embedded Figures Test. Comparisons of the adolescents and adults with anorexia nervosa revealed no significant differences for any of the neuropsychological test scores even after adjusting for potential confounding factors. Neither cognitive flexibility nor attention to detail were associated with level of eating disorder symptomatology, depression, anxiety or obsessive-compulsive symptomatology. Unlike age, illness duration was found weakly associated with perseverative errors Wisconsin Card Sorting Test and with the central coherence index of the Rey Complex Figure recall condition. Set-shifting and central coherence performance were independent of age, clinical symptoms severity and emotional status. Additional studies on the relationship between the duration of anorexia nervosa and neuropsychological difficulties are needed.