Set-shifting Ability Research Articles

The Time Course of Changes in Prefrontal Cortex Activity During Walking in People With Parkinson’s Disease

Background Walking abnormalities in people with Parkinson’s disease (PD) are characterized by a shift in locomotor control from healthy automaticity to compensatory, executive control, mainly located in the prefrontal cortex (PFC). Although PFC activity during walking increases in people with PD, the time course of PFC activity during walking and its relationship to clinical or gait characteristics is unknown. Objective To identify the time course of PFC activity during walking in people with PD. To investigate whether clinical or gait variables would explain the PFC activity changes. Methods Thirty-eight people with PD tested OFF medication wore a portable, functional near-infrared spectroscopy (fNIRS) system to record relative PFC activity while walking. Wearable inertial sensors recorded spatiotemporal gait characteristics. Based on the PFC activity (fNIRS) in the late phase of the walking task (final 40 seconds), compared to the early phase (initial 40 seconds), participants were separated into 2 groups: reduced or sustained PFC activity. Results People with PD who reduced PFC activity during walking had less impaired gait (eg, faster gait speed) than those who had a sustained increase in PFC activity (P < .05). Cognitive set-shifting ability explained 18% of the PFC activation in the group with a sustained increase in PFC activity (P = .033). Conclusions The time course of reduction in PFC activity corresponds to less impaired gait performance in people with PD, while a sustained increase in PFC activity is related to worse cognitive flexibility. Reduction in PFC activity while walking may indicate a less impaired, automatic control of walking.

Exploring neurocognitive features in adolescents and young adults with anorexia nervosa: Evidence from a longitudinal study.

We aimed to evaluate longitudinal changes in set-shifting and central coherence in a predominantly adolescent cohort with anorexia nervosa (AN) and to explore whether these factors predict long-term eating disorder outcomes. Ninety-two female patients with AN (mean age: 16.2, range: 13-21years) completed neurocognitive tests (Rey Complex Figure Test, Adapted Version of the Wisconsin Card Sorting Test) before and after 12months of psychotherapeutic treatment (n=45 Maudsley AN Treatment, MANTRa; n=47 standard psychotherapy; groups not randomised). Eating disorder severity was assessed at baseline, after 6, 12 and 18months. Central coherence (indicated by an increase in the Rey Figure Style Index) and set-shifting (indicated by a reduction in the percentage of perseverative errors) significantly improved over the course of treatment, with similar outcomes across groups. Lower central coherence was associated with higher eating disorder severity. Individuals with lower baseline set-shifting ability tended to have worse eating disorder outcomes in the long-term. However, this trend did not reach statistical significance in a multilevel linear mixed model. Neurocognitive difficulties in adolescents and young adults with AN can improve after treatment. Interventions specifically addressing flexibility in thinking and behaviour may contribute to treatment success.

0964 Depression Moderates the Effect of Repetitive Negative Thinking on Set-shifting Ability in Youth with Insomnia

0964 Depression Moderates the Effect of Repetitive Negative Thinking on Set-shifting Ability in Youth with Insomnia

Clinical and neuropsychological correlates of theta-band functional excitation-inhibition ratio in autism: An EEG study

ObjectiveHow abnormal brain signaling impacts cognition in autism spectrum disorder (ASD) remained elusive. This study aimed to investigate the local and global brain signaling in ASD indicated by theta-band functional excitation-inhibition (fE/I) ratio and explored psychophysiological relationships between fE/I, cognitive deficits, and ASD symptomatology. MethodsA total of 83 ASD and typically developing (TD) individuals participated in this study. Participants’ interference control and set-shifting abilities were assessed. Resting-state electroencephalography (EEG) was used for estimating theta-band fE/I ratio. ResultsASD individuals (n = 31 without visual EEG abnormality; n = 22 with visual EEG abnormality) generally performed slower in a cognitive task tapping interference control and set-maintenance abilities, but only ASD individuals with visually abnormal EEG performed significantly slower than their TD counterparts (Bonferroni-corrected ps < .001). Heightened theta-band fE/I ratios at the whole-head level, left and right hemispheres were observed in the ASD subgroup without visual EEG abnormality only (Bonferroni-corrected ps < .001), which remained highly significant when only data from medication-naïve participants were analyzed. In addition, higher left hemispheric fE/I ratios in ASD individuals without visual EEG abnormality were significantly correlated with faster interference control task performance, in turn faster reaction time was significantly associated with less severe restricted, repetitive behavior (Bonferroni-corrected ps ≤ .0017). ConclusionsDifferential theta-band fE/I within the ASD population. Heightened theta-band fE/I in ASD without visual EEG abnormality may be associated with more efficient filtering of distractors and a less severe ASD symptom manifestation. SignificanceBrain signaling, indicated by theta-band fE/I, was different in ASD subgroups. Only ASD with visually-normal EEG showed heightened theta-band fE/I, which was associated with faster processing of visual distractors during a cognitive task. More efficient distractor filtering was associated with less restricted, repetitive behaviors.

The effectiveness of rational emotive behavior therapy (REBT) and mindfulness-based intervention (MBI) on psychological, physiological and executive functions as a proxy for sports performance

BackgroundIn the current study, we conducted a comparative analysis involving three distinct groups: one receiving group-based rational emotive behavior therapy (REBT), another undergoing a mindfulness-based intervention (MBI), and a third group serving as the control. The aim of the study was to explore the effectiveness of the two interventions on specific psychological (competitive anxiety, perfectionism, irrational beliefs), physiological (salivary cortisol levels), and neurocognitive (executive functions: working memory, inhibition, cognitive flexibility) functions in Hungarian junior ice hockey players.MethodsThe participants consisted of 10 females and 36 males (NREBT=12, NMINDFULNESS=14, NCONTROL=20). We used questionnaires to assess competitive anxiety, perfectionism, and irrational beliefs. The components of executive functions were measured using a computerized testing system, while cortisol levels were examined through salivary samples. Prior to and after the interventions, each participant underwent all measurements, after which we conducted repeated measures ANOVA on our data.ResultsWe found REBT to be an effective intervention for the regulation of competitive anxiety, perfectionism, and irrational beliefs as well as for improving some components of executive functions (inhibition and cognitive flexibility). Mindfulness was found to improve athletes’ processing speed and set-shifting abilities, which are related to cognitive flexibility and metacognitive processes.ConclusionIn conclusion, we explore implications of these findings regarding how each approach is posited to enhance sports performance, using neurocognitive functions as a proxy. These findings are useful for further research and practical implications.

75 Examining the Role of Executive Functions on the Intention-Behavior Gap of Alcohol Harm Reduction Strategy Use

Objective:The Temporal Self-Regulation Theory (Hall and Fong, 2007) proposes that initiation and maintenance of effortful health behaviors relies on executive functions (EF: cognitive abilities associated with goal-directed behavior). Alcohol harm reduction strategies are health behaviors that aim to minimize the likelihood or severity of consequences associated with alcohol use. Some drinkers have the intention to drink safely but lack the ability to effectively initiate and execute the harm reduction behaviors. Executive functions may be one mechanism that helps explain the gap between safe drinking intentions and behavior. Specific components of EF may be differentially associated with alcohol harm reduction strategy use; working memory and set-shifting may be especially important in planning and following through with alcohol harm reduction strategies, and individuals with greater working memory capacity and set-shifting abilities may be more successful in implementing strategies that require preplanning and have a focus on altering typical the manner of drinking (e.g., not mixing types of alcohol). Inhibition may be important for resisting temptations that are inconsistent with safe drinking goals, and those with stronger inhibitory control may be more likely to follow through with strategies that require withholding responses despite desire to engage in the behavior, such as stopping or limiting drinking (e.g., not exceeding a predetermined number of drinks).Participants and Methods:Using ecological momentary assessment, the current study explored the extent to which an intention-behavior gap in harm reduction strategy use exists among college student drinkers (n=77), and investigated how potential individual differences in EF (i.e., working memory, set-shifting, and inhibition) were associated with translating intentions of drinking safely into action. Daily monitoring assessments contained brief measures of intention to use harm reduction strategies, actual strategy use, and alcohol-related behaviors, and were assessed daily for twenty-one days.Results:Multilevel model analyses revealed that although intention to use strategies predicted actual strategy use, measures of EF did not significantly moderate the relationship. Exploratory analyses indicated that set-shifting significantly moderated the intention-behavior gap for a subset of harm reduction strategies that relies more heavily on modifying behavior during a drinking event. Set-shifting did not significantly moderate the intention-behavior gap for a subset of strategies that relies more heavily on pre-planning before the drinking event.Conclusions:Findings from the current study suggests that those who plan to use strategies typically follow through regardless of individual differences in EF. Efforts to increase intention to drink safely can be incorporated into existing alcohol prevention and intervention programs, which would likely lead to increased use of harm reduction strategies and decreased alcohol-related consequences.

16 Set-Shifting as a Predictor of Adaptive Functioning in Individuals with Acquired Brain Injury

Objective:Cognitive flexibility, typically measured using neuropsychological tasks of set-shifting, has been associated with mental and physical health, social relationships, resilience, and overall quality of life (Diamond, 2013; Chen et al., 2014; Davis et al., 2010; de Abreu et al., 2014; Genet et al., 2011). Previous research has found conflicting results regarding the relationship between set-shifting and various measures of functional outcomes in individuals with traumatic brain injury (Allanson et al., 2017). The present study examined the relationship between cognitive flexibility and adaptive functioning in individuals with acquired brain injuries (ABI).Participants and Methods:Participants in this research are adults (n = 116) with severe, chronic ABI who completed a neuropsychological evaluation through Bancroft Neurorehab between 2012-2022. Participants ranged in age from 20.4 - 67.8 years (M = 45.8). Individuals included in data analysis completed Trails A and B, Wide Range Achievement Test, Fourth Edition (WRAT-4) Word Reading, and Texas Functional Living Scale (TFLS). Set-shifting ability was measured using Trails B and adaptive functioning was measured using the TFLS. Word reading ability, measured using the WRAT-4, was included as a covariate to account for the impact of word reading difficulties on Trails B performance.Results:A simple linear regression was conducted to examine if Trails B T-score (M = 24.7) and WRAT-4 Word Reading Standard Score (M = 87.8) predicted TFLS Total T-score (M = 35.8). The overall regression model was statistically significant (R2 = .351, F(2, 113) = 32.0, p &lt; .001). It was found that lower performances on Trails B (ß = .272, p &lt;.001) and WRAT-4 Word Reading (ß = .189, p &lt;.001) both significantly predicted a lower TFLS Total T-score.Conclusions:Set-shifting and word reading ability significantly predicted the overall adaptive functioning score on the TFLS which adds to a body of literature that suggests that the ability to think and behave flexibly affects functional aspects of everyday living. These findings are consistent with previous literature regarding the association between cognitive flexibility and adaptive functioning in the general population, and these results add to the growing body of research on cognitive flexibility in individuals with brain injury. Clinicians may use an individual’s set-shifting performance to estimate and further assess potential difficulties in completing activities of daily living. This information may assist in subsequent treatment planning and identifying treatment goals of cognitive rehabilitation consistent with rehabilitation psychology’s goals of increasing levels of adaptive functioning and quality of life (Division 22 of the American Psychological Association, n.d.). Future research may examine if certain domains of adaptive functioning are more or less affected by impairments in cognitive flexibility. Future research may also examine patterns of set-shifting performance, such as sequencing errors vs. set-loss errors, associated with specific areas of insult.

The Impact of Exam Stress on the Relationship Between Autistic Traits and Disordered-Eating Attitudes in a Non-clinical Population

Previous research has demonstrated that individuals with anorexia nervosa display elevated autistic traits in comparison to individuals who do not have the disorder. However, it remains unknown as to whether this relationship is a stable trait of individuals or if it is caused by a psychological or physical state. This study investigated the state vs trait nature of the relationship between disordered eating and autistic traits in a non-clinical sample, while additionally exploring the ability of cognitive inflexibility to predict this relationship. Thirty-four undergraduate students from the University of St Andrews completed questionnaires regarding their affect, disordered-eating attitudes and autistic traits alongside a measure of set-shifting ability in the Brixton Spatial Anticipation test during a period of examination stress and a period of no stress. It was revealed that on both occasions, individuals who scored higher on a test of disordered-eating attitudes also scored higher on a test measuring autistic traits. This relationship was stronger when participants were stressed. Autistic traits were also found to significantly predict a change in eating attitudes between a stress-induced state and pre-existing trait conditions. Inflexibility, as reflected by Brixton scores, did not appear to relate to either measure. These results indicate that slightly elevated autistic traits in those exhibiting disordered-eating attitudes may be state-dependent, as opposed to reflecting the engrained traits of the individual. Findings are discussed in relation to future research replicating the study with a larger sample and implications for the diagnosis and treatment of anorexia.

Impaired cognitive flexibility across psychiatric disorders.

Problems with cognitive flexibility have been associated with multiple psychiatric disorders, but there has been little understanding of how cognitive flexibility compares across these disorders. This study examined problems of cognitive flexibility in young adults across a range of psychiatric disorders using a validated computerized trans-diagnostic flexibility paradigm. We hypothesized that obsessive-compulsive spectrum disorders (eg, obsessive-compulsive disorder, trichotillomania, and skin-picking disorder) would be associated with pronounced flexibility problems as they are most often associated with irrational or purposeless repetitive behaviors. A total of 576 nontreatment seeking participants (aged 18-29years) were enrolled from general community settings, provided demographic information, and underwent structured clinical assessments. Each participant undertook the intra-extra-dimensional task, a validated computerized test measuring set-shifting ability. The specific measures of interest were total errors on the task and performance on the extra-dimensional (ED) shift, which reflects the ability to inhibit and shift attention away from one stimulus dimension to another. Participants with depression and PTSD had elevated total errors on the task with moderate effect sizes; and those with the following had deficits of small effect size: generalized anxiety disorder (GAD), obsessive-compulsive disorder (OCD), antisocial personality disorder, and binge-eating disorder. For ED errors, participants with PTSD, GAD, and binge-eating disorder exhibited deficits with medium effect sizes; those with the following had small effect size deficits: depression, social anxiety disorder, OCD, substance dependence, antisocial personality disorder, and gambling disorder. These data indicate cognitive flexibility deficits occur across a range of mental disorders. Future work should explore whether these deficits can be ameliorated with novel treatment interventions.

The GluA1-Related BDNF Pathway Is Involved in PTSD-Induced Cognitive Flexibility Deficit in Attentional Set-Shifting Tasks of Rats.

Background: Post-Traumatic Stress Disorder (PTSD) is a severe psychological disorder characterized by intrusive thoughts, heightened arousal, avoidance, and flashbacks. Cognitive flexibility dysfunction has been linked with the emergence of PTSD, including response inhibition deficits and impaired attentional switching, which results in difficulties for PTSD patients when disengaging attention from trauma-related stimuli. However, the molecular mechanisms of cognitive flexibility deficits remain unclear. Methods: The animals were exposed to a single prolonged stress and electric foot shock (SPS&S) procedure to induce PTSD-like features. Once the model was established, the changes in cognitive flexibility were assessed using an attentional set-shifting task (ASST) in order to investigate the effects of traumatic stress on cognitive flexibility. Additionally, the molecular alterations of certain proteins (AMPA Receptor 1 (GluA1), brain-derived neurotrophic factor (BDNF), and Postsynaptic density protein 95 (PSD95) in the medial prefrontal cortex (mPFC) were measured using Western blot and immunofluorescence. Results: The SPS&S model exhibited PTSD-like behaviors and induced reversal learning and set-shifting ability deficit in the ASST. These behavioral changes are accompanied by decreased GluA1, BDNF, and PSD95 protein expression in the mPFC. Further analysis showed a correlative relationship between the behavioral and molecular alterations. Conclusions: The SPS&S model induced cognitive flexibility deficits, and the potential underlying mechanism could be mediated by GluA1-related BDNF signaling in the mPFC.

Effects of transcranial direct current stimulation on improving performance of delayed- reinforcement attentional set-shifting tasks in attention-deficit/hyperactivity disorder rat model

Behavioral flexibility (or set-shifting), which is regulated by the prefrontal cortex (PFC), is often impaired in patients with attention-deficit/hyperactivity disorder (ADHD), which is characterized by poor inhibitory control and reinforcement learning. Transcranial direct current stimulation (tDCS) has been proposed as a means of noninvasive brain stimulation and a potential therapeutic tool for modulating behavioral flexibility. Animal studies can pave the way to know if tDCS application can potentially benefit rule- and goal-based activities in ADHD. Spontaneously hypertensive rats (SHRs) and inbred Wistar–Kyoto (WKY) rats were used as an animal model of ADHD and controls, respectively, and their strategy set-shifting abilities, including initial discrimination, set-shifting, and reversal learning tasks under 0-s or 15-s reinforcer delivery delay conditions, were evaluated. The tDCS treatment had a limited effect on the performance of the SHRs and WKY rats in initial discrimination task under 0-s delay condition. Under the 15-s delay condition, the SHRs had longer lever-press reaction times and/or more trial omissions than the WKY rats did when completing set-shifting and reversal-learning tasks. Among the SHRs, tDCS treatment improved the rats’ reaction times and/or reduced their trial omissions in the set-shifting and reversal-learning tasks. Although tDCS may improve delayed reinforcement learning set-shifting performance in SHRs, further studies are required to clarify the responsible mechanism.

Assessment of executive function in a rodent model of Type 1 diabetes

This study examined the impact of Type 1 Diabetes Mellitus (T1DM) on executive function using a series of operant conditioning-based tasks in rats. Sprague Dawley rats were randomized to either non-diabetic (n = 12; 6 male) or diabetic (n = 14; 6 male) groups. Diabetes was induced using multiple low-dose streptozotocin injections. All diabetic rodents were insulin-treated using subcutaneous insulin pellet implants (9–15 mM). At week 14 of the study, rats were placed on a food restricted diet to induce 5–10 % weight loss. Rodents were familiarized and their set-shifting ability was tested on a series of tasks that required continuous adjustments to novel stimulus-reward paradigms in order to receive food rewards. Results showed no differences in the number of trials, nor number and type of errors made to successfully complete each task between groups. Therefore, we report no differences in executive function, or more specifically set-shifting abilities between non-diabetic and diabetic rodents that receive insulin.

Nucleus Accumbens Core Dopamine D2 Receptor-Expressing Neurons Control Reversal Learning but Not Set-Shifting in Behavioral Flexibility in Male Mice.

The ability to use environmental cues to flexibly guide responses is crucial for adaptive behavior and is thought to be controlled within a series of cortico-basal ganglia-thalamo-cortical loops. Previous evidence has indicated that different prefrontal cortical regions control dissociable aspects of behavioral flexibility, with the medial prefrontal cortex (mPFC) necessary for the ability to shift attention to a novel strategy (set-shifting) and the orbitofrontal cortex (OFC) necessary for shifting attention between learned stimulus-outcome associations (reversal learning). The nucleus accumbens (NAc) is a major downstream target of both the mPFC and the OFC; however, its role in controlling reversal learning and set-shifting abilities is still unclear. Here we investigated the contribution of the two major NAc neuronal populations, medium spiny neurons expressing either dopamine D1 or D2 receptors (D1-/D2-MSNs), in guiding reversal learning and set-shifting in an attentional set-shifting task (ASST). Persistent inhibition of neurotransmitter release from NAc D2-MSNs, but not D1-MSNs, resulted in an impaired ability for reversal learning, but not set-shifting in male mice. These findings suggest that NAc D2-MSNs play a critical role in suppressing responding toward specific learned cues that are now associated with unfavorable outcomes (i.e., in reversal stages), but not in the suppression of more general learned strategies (i.e., in set-shifting). This study provides further evidence for the anatomical separation of reversal learning and set-shifting abilities within cortico-basal ganglia-thalamo-cortical loops.

Psychobiological foundations of coping and emotion regulation: Links to maltreatment and depression in a racially diverse, economically disadvantaged sample of adolescent girls

Adolescent risk for depression and passive or active suicidal ideation (PASI) involves disturbance across multiple systems (e.g., arousal regulatory, affective valence, neurocognitive). Exposure to maltreatment while growing up as a child or teenager may potentiate this risk by noxiously impacting these systems. However, research exploring how coordinated disturbance across these systems (i.e., profiles) might be uniquely linked to depressogenic function, and how past maltreatment contributes to such disturbance, is lacking. Utilizing a racially diverse, economically disadvantaged sample of adolescent girls, this person-centered study identified psychobiological profiles and linked them to maltreatment histories, as well as current depressive symptoms and PASI. Girls (N = 237, Mage=13.98, SD=0.85) who were non-depressed/non-maltreated (15.1%), depressed/non-maltreated (40.5%), or depressed/maltreated (44.4%) provided morning saliva samples, completed questionnaires, a clinical interview, and a neurocognitive battery. Latent profile analysis of girls’ morning cortisol:C-reactive protein ratio, positive and negative affect levels, and attentional set-shifting ability revealed four profiles. Relative to Normative (66.6%), girls exhibiting a Pro-inflammatory Affective Disturbance (13.1%), Severe Affective Disturbance (10.1%), or Hypercortisol Affective Neurocognitive Disturbance (n = 24, 10.1%) profile reported exposure to a greater number of maltreatment subtypes while growing up. Girls exhibiting these dysregulated profiles were also more likely (relative to Normative) to report current depressive symptoms (all three profiles) and PASI (only Pro-inflammatory Affective Disturbance and Hypercortisol Affective Neurocognitive Disturbance). Of note, girls’ cognitive reappraisal utilization moderated profile membership–depression linkages (depressive symptoms, but not PASI). A synthesis of the findings is presented alongside implications for person-centered tailoring of intervention efforts.

The associations of insomnia symptoms with daytime behavior and cognitive functioning in children with attention-deficit/hyperactivity disorder.

The current study aimed to examine the association of insomnia symptoms with daytime behavior and cognitive functioning in children with attention-deficit/hyperactivity disorder (ADHD). Thirty-six children with ADHD and insomnia symptoms, 27 children with ADHD without insomnia symptoms, and 21 age-matched healthy controls were recruited in this study (age range: 6-12 years, 70% male). They were assessed by parent-report questionnaires on insomnia symptoms (Children's Sleep Habits Questionnaire) and ADHD symptoms (Strengths and Weaknesses of ADHD Symptoms and Normal Behavior Scale [SWAN]), and completed a battery of cognitive tests including the Continuous Performance Test (CPT) for sustained attention, Letter-digit test for processing speed, Digit Span forward test and N-back task for working memory, Tower of London (TOL) test for planning skills and Bergs Card Sorting Test (BCST) for set-shifting ability. Children with ADHD and insomnia symptoms had the highest scores on SWAN total and inattention and hyperactivity subscales, followed by children with ADHD without insomnia and healthy controls (all P < .05). After controlling for potential confounders, children with ADHD and insomnia symptoms showed poorer performance on the CPT and Letter-digit test as compared with children with ADHD without insomnia and healthy controls (all P < .05). Insomnia symptoms are associated with more severe ADHD symptoms and cognitive impairments in children with ADHD, especially deficits in sustained attention and processing speed. Future longitudinal studies are needed to explore the long-term impacts of insomnia symptoms and the effects of sleep-focused intervention on cognitive functioning in children with ADHD. Li X, Shea KSC, Chiu WV, etal. The associations of insomnia symptoms with daytime behavior and cognitive functioning in children with attention-deficit/hyperactivity disorder. J Clin Sleep Med. 2022;18(8):2029-2039.

Set-shifting and inhibition interplay affect the rule-matching bias occurrence during conditional reasoning task.

The rule-matching bias is a common error during conditional reasoning tasks, which refers to a tendency to match responses with the lexical context in the conditional rule and leads to incorrect responses. Conditional reasoning is one of the higher-level cognitive abilities affected by many cognitive skills. We aimed to determine whether inhibition and set-shifting skills with rule-matching bias occurrence could be related and, if so, to what quantitative, at a statistically significant level. A total of 30 healthy university students aged 18 to 30 participated in this study. We used the Wason's Selection Task (WST) to measure conditional reasoning and investigated their inhibition and set-shifting skills with the Stroop and Wisconsin Card Sorting Test, respectively. Results showed a significant positive correlation between the number of correct responses to the Stroop test and the Wason Selection Card Test (p=0.614). There was a positive correlation between the number of correct responses to the Wisconsin Card Sorting Test and the Wason Selection Card Test (p=0.423). Participants with higher inhibition and set-shifting abilities showed better performance in the conditional reasoning test and lower rule-matching bias errors.

Cognitive and Experienced Flexibility in Patients With Anorexia Nervosa and Obsessive Compulsive Disorder.

ObjectiveAnorexia nervosa (AN) and obsessive-compulsive disorder (OCD) share a neuropsychological profile characterized by cognitive inflexibility as evident in set-shifting problems, and by strong detail focus. Clinically, both patient groups display a strong rigidity which may be explained by these neurocognitive difficulties. Cognitive inflexibility may hinder treatment uptake and help explain suboptimal treatment outcomes in both AN and OCD. This is the first study to compare clinical AN and OCD groups andto examine similarities and differences in cognitive flexibility. Specifically, this study aims to investigate neuropsychological outcomes and self-reported difficulties in both clinical groups and a control group, and explore associations between the different flexibility outcomes and illness.MethodTwo hundred participants (61 AN, 72 OCD and 67 HC) performed neuropsychological tasks on set-shifting abilities (Trail Making Task, Stroop color-word interference, Intradimensional-Extradimensional shift task), detail focus (Group Embedded Figures Test) and self-reported set-shifting abilities and attention to detail (DFlex).ResultsSimilarities between patient groups were found in terms of reduced set-shifting ability on the Trail Making Task and detail focus. Moreover, both patient groups self-reported more set-shifting problems but a less strong detail focus than HC, which in turn were not related to neuropsychological task outcomes in either of the groups. In both patient groups longer illness duration was associated to longer reaction times in the switching tasks and for both groups symptom severity was associated to higher experienced inflexibility and attention to detail.ConclusionCognitive inflexibility processes are largely similar in patients with AN and OCD. Both patient groups report inflexibility, yet this is unrelated to neuropsychological outcomes. Illness duration seems to contribute to poorer set-shifting and higher illness severity is linked to more experienced inflexibility. Findings highlight the need for entangling different domains of cognitive flexibility and detail focus and examining self-report measures for a cohesive understanding of clinically relevant flexibility weaknesses in AN and OCD.

No influence of sex on the relationship between schizotypy factors and executive control across the schizophrenia spectrum

Sex differences in symptoms and executive control across schizophrenia spectrum disorders (SSD) are consistently reported. Similarly, these findings of sex differences are also observed in schizotypy, that is, schizophrenia-like features occurring in healthy individuals in the absence of a clinical diagnosis. This study aimed to examine the relationships between performance on three major domains of executive control: performance monitoring, response inhibition, and cognitive set-shifting, and schizotypy factor scores in both SSD patients and healthy controls (HCs), and whether sex moderated any relationships observed. A total of 111 (67 males and 44 females) patients with SSD and 258 (129 males and 129 females) HCs were included in this study. Schizotypal personality traits (in both SSD and HC) was assessed using the Oxford-Liverpool Inventory of Feelings and Experiences (O-LIFE). Executive control performance was assessed using seven tasks. Stepwise linear regressions revealed that performance on cognitive set-shifting tasks was significantly associated with the introvertive anhedonia, cognitive disorganisation, and unusual experiences subscales of the O-LIFE. When sex was examined as a moderator, it was not a significant moderator of any of the relationships between cognitive set-shifting tasks and schizotypy factors. The results suggest that independent of sex, cognitive set-shifting ability is associated to an increased vulnerability to schizotypal personality traits, although performance monitoring and response inhibition did not.

Executive functions and eating behavior: Commentary on Steegers et al. (2021).

Alterations in executive functions have repeatedly been found in individuals suffering from eating and weight disorders. However, less is known about how these cognitive processes might contribute to the etiology of the disorders, as large prospective population-based studies have been missing. Here, we comment on the results of Steegers et al. (2021), a study that helped to fill this gap with a focus on set-shifting abilities predicting symptoms of anorexia nervosa (AN) in children. The main goal of this commentary is to encourage further interpretation of the population-based data beyond its relevance to AN. More specifically, we discuss the role of impaired inhibition as a risk factor for weight gain and obesity.

The longitudinal relationship between set-shifting at 4 years of age and eating disorder related features at 9 years of age in the general pediatric population.

BackgroundIndividuals with anorexia nervosa (AN) tend to have rigid thoughts and behaviors regarding their body weight, body image, and eating habits. While a diagnosis of AN implies severe levels of impairment, AN traits can vary on a continuum within the population. However, little is known about how early markers of AN relate to rigid thought patterns and to what extent cognitive rigidity is already present in early childhood. We examined the association of set‐shifting abilities as a measure of cognitive flexibility in preadolescents with AN‐related features.MethodsParticipants included 3,987 children participating in the Generation R Study, a Dutch population‐based birth cohort. Set‐shifting abilities (mother report) were assessed at 4 years of age, body mass index (BMI) was determined at 4 and 9 years and restrictive eating patterns (mother report) and body image (child report) were assessed at 9 years.ResultsLower set‐shifting abilities at 4 years were associated with a lower BMI (β = −.44, p = 2.2 × 10−4) in girls, and more restrictive eating (β = 0.15, p = 2.7 × 10−6) in both boys and girls at 9 years of age. Moreover, set‐shifting at age 4 was not associated with body image at age 9.ConclusionThese findings contribute to the idea that the association between set‐shifting problems and AN‐related features are present early in childhood, prior to the typical range of the onset of eating disorders (EDs). Longitudinal studies that capture the peak age for the development of EDs will be important to assess whether early cognitive inflexibility is an early marker of AN.