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Table 1 Summary of studies included in the review

From: Are poor set-shifting and central coherence associated with everyday function in anorexia nervosa? A systematic review

Author (year)

Sample

Cognitive measures

Function measures

Results

Oldershaw, Lavender & Schmidt [60]

AN (n = 71)

Outpatients.

Age over 18 years,

M age = 26

WCST, Brixton, TMT, GEFT

CIA

Cognitive tests did not predict CIA scores.

Bentz et al. [9]

AN (n = 71)

43 first episode M age = 16, 28 recovered M age = 18.

HC (n = 41)

Age 14–22 years.

D-KEFS: Composite set-shifting measure (shift conditions of Verbal Fluency, Design Fluency and Trail Making), GEFT

ADOS

Composite SS and GEFT did not predict ADOS social function.

Hamatani et al. [36]

AN (n = 21: AN-BP = 13,

AN-R = 8).

14 outpatients,

7 inpatients.

Adults, M age = 32 years.

HC (n = 25).

KWCST, ROCFT

SF-36

Greater KWCST DMS associated with lower scores on SF-36 PCS (r = − 0.658, p = < .05).

ROCFT CCI 30-min delay recall score associated with

SF-36 MCS (r = 0.610, p = < .05).

Westwood, Mandy & Tchanturia [94]

AN (n = 99)

Inpatients and outpatients. Age 12–47 years.

WCST, ROCFT, D-Flex

ADOS

Greater WCST %PE associated with increased ASD symptoms, Welch’s F (2,59.77) = 3.77, p = .029.

D-flex increase in cognitive rigidity scores between no vs. high ASD symptoms, p = .018

ROCFT not associated with increased ASD symptoms.

Renwick et al. [67]

AN (n = 100; AN-R = 44, AN-BP = 33, EDNOS-AN = 23) Outpatients.

Adults, M age = 24.7 years.

WCST, Brixton, ROCFT

CIA

Reading the Mind in Films Task

Cluster (17% of participants) show poor performance on WCST, ROCFT CCI and RMIF emotional ToM.

No effect of cluster for ROCFT, but overall poor performance. No effect of cluster for CIA.

Talbot, Hay & Touyz [79]

AN (n = 49; 24 acute,

10 weight-recovered, 15 fully recovered)

HC (n = 43)

Age 19–27 years.

WCST, ROCFT,  MFFT

EDQOL, IIP-32

WCST PE higher scaled scores (better performance) associated with higher IIP-32 ‘Too dependent’

(r = .305, p = .033), ‘Too aggressive’ (r = .401, p = .004), ‘Hard to be involved’ (r = .313, p = .029) and

‘Hard to be supportive’ (r = .294, p = .040).

WCST CC associated with higher IIP-32 ‘Too dependent’ (r = .354, p = .013), ‘Too aggressive’ (r = .334, p = .019) and better financial QOL (r = −.393, p = .007).

ROCFT lower CCI and OCI associated with higher IIP-32 ‘Hard to be supportive’ (CI: r = −.336, p = .020; OCI:

(r = −.413, p = .004) and lower OCI associated with higher IIP-32 ‘Hard to be involved’ (r = −.343, p = .017).

Calderoni et al. [14]

AN-R (n = 23)

HC (n = 46)

Age 9–16 years.

NEPSY-II Attention and EF: Auditory response set, Inhibition shifting

NEPSY-II Social Perception: ToM verbal, ToM contextual and Affect recognition

NEPSY-II Attention and EF no group differences on overall domain but response set shifting test worse in AN vs. HC (t67 = − 2.17, p = .033).

No group differences on NEPSY-II inhibition shifting or NEPSY-II social perception domain.

Harrison, Tchanturia, Naumann & Treasure [38]

AN (n = 85; 35 AN-R, 15 AN-BP, 35 recovered)

HC (n = 90)

Age 18–55 years.

WCST, Brixton,

ROCFT, GEFT, FPT

Reading the Mind in the Eyes test

Higher WCST PE associated with lower Reading the Mind in the Eyes emotion recognition (rs = −.281, p = .05), but not significant after Bonferroni correction.

Executive function in daily life

Spitoni, Aragonaa, Bevacqua, Cotugno & Antonucci [75]

AN-R (n = 62)

HC (n = 70)

Age 16–42 years.

WCST, TMT, ROCFT

BADS

AN WCST PE higher (partial ƞ2 = .03) and TMT-B slower (partial ƞ2 = .10) than HC. AN lower ROCFT CCI than HC at 30s (partial ƞ2 = .13) and 20 min recall (partial ƞ2 = .11). AN BADS accuracy similar, but AN slower than HC across tasks (Rule shift cards time: partial ƞ2 = .14; Key search time: partial ƞ2 = .83, Zoo map planning time: partial ƞ2 = .18; Zoo Map execution time partial ƞ2 = .12)

Herbrich, Kappel, van Noort & Winter [39]

AN (n = 111; AN-R = 90,

AN-BP = 21)

HC (n = 63)

Age 9–17 years.

WCST, TMT, ROCFT, GEFT

BRIEF-SR

AN-R TMT-4 faster than HC (d = .39)

No group differences for WCST, ROCFT or GEFT.

BRIEF-SR: ‘Shift’ subscale both subtypes higher than HC (AN-R; d = −.89) and (AN-BP; d = − 1.41) and AN-BP higher than AN-R (d = .57).

van Noort, Kraus, Pfeiffer, Lehmkuhl & Kappel [89]

AN (n = 20)

15 inpatients,

5 outpatients.

HC (n = 20)

Age 12–18 years.

TMT, ROCFT

BRIEF-SR

No group differences for TMT or ROCFT at baseline. Irrespective of time point, AN less flexible than HC on BRIEF-SR subscales ‘Cognitive shift’ (partial ƞ2 = −.207), ‘Behavioral shift’ (partial ƞ2 = −.230).

Stedal & Dahlgren [76]

AN (n = 20, AN-R = 18,

AN-BP = 2).

10 in-, 10 outpatients

Age 13–18 years.

D-KEFS: TMT-4, Color-word interference test-4 and verbal fluency-3, Brixton, ROCFT

BRIEF-SR

BRIEF-PF

All neurocognitive test scores, BRIEF-SR and BRIEF-PF were within normal range.

McAnarney et al. [54]

AN-R (n = 24)

HC (n = 37)

Age 14–20 years.

WCST, CANTAB ID/ED

BRIEF-SR

BRIEF-PF

AN-R no significant differences in WCST PE or CANTAB ID/ED. AN-R greater set-shifting difficulties than HC on BRIEF-PF (M = 54.5 vs. 47, p = <.008) and BRIEF-SR (p = .057). BRIEF-SR ‘Behavioral Shift’ sub-scale scores show larger difference (M = 64.1 vs. 48.5, p = <.008) than ‘Cognitive Shift’ (M = 54.9 vs. 48.7, p = <.008).

  1. Abbreviations: ADOS Autism Diagnostic Observation Schedule, BADS Behavioral Assessment of Dysexecutive Syndrome, BRIEF-PF Behavior Rating Inventory of Executive Function Parent Form, BRIEF-SR Behavior Rating Inventory of Executive Function Self-Report, Brixton Brixton Spatial Anticipation Test, CANTAB ID/ED Intra/Extradimensional Set Shift subtest of the Cambridge Neuropsychological Automated Battery, CCI Central Coherence Index, CIA Clinical Impairment Assessment, D-KEFS Delis-Kaplan Executive Function System, DFlex Detail and Flexibility questionnaire, EDQoL Eating Disorder Quality of Life scale, FPT Fragmented Pictures Task, GEFT Group Embedded Figures Test, IIP-32 Inventory of Interpersonal Problems, KWCST Wisconsin Card Sort Test Keio version, KWCST DMS Wisconsin Card Sort Test Keio version Difficulty Maintaining Set, MFFT Matching Familiar Figures Test, ROCFT Rey-Osterreith Complex Figure Task, ROCFT OCI Rey-Osterreith Complex Figure Task Order of Construction Index, SF-36 Short Form Health Survey, SF-36 PCS Short Form Health Survey Physical Component Summary, SF-36 MCS Short Form Health Survey Mental Component Summary, TMT Trail Making Test, ToM Theory of Mind, WCST Wisconsin Card Sort Task, WCST CC Wisconsin Card Sort Task Categories Completed, WCST PE Wisconsin Card Sort Task Perseverative Errors, WCST %PE Wisconsin Card Sort Task percentage Perseverative Errors. See Tables 2 and 3 for details of included measures