Executive functioning in anorexia nervosa: Exploration of the role of obsessionality, depression and starvation

Cognitive deficits related to executive functioning have been previously identified in anorexia nervosa (AN). Currently, there is limited knowledge about the degree to which other variables related to AN or executive function may influence the observed relationships. The present study examined three groups of participants, women with AN (n = 22), and two control groups: women who were high in obessionality (n = 20) and women who were low in obsessionality (n = 21). Women reporting disordered eating over the previous 4 weeks were screened out of the control groups. Executive function was measured using the Wisconsin card sorting test (WCST) and the uses of common objects test (UCOT). In addition, depression, obsessionality and body mass index were measured. Initial analyses showed no significant differences between the groups on executive function, but moderate effect sizes were obtained for performance on UCOT total perseverations and WCST total trials. When controlling for either depression or obsessionality, the group differences on the UCOT total perseverations became significant and in the case of depression attained a large effect size. Both the AN and high obsessional groups showed significantly more perseverations than the low obsessional group. Depression appeared to suppress variance that was irrelevant to the prediction of perseverance thus enhancing the importance of group membership. It is recommended that variables strongly associated with AN be investigated in future research as this may clarify the relationship between AN and executive function.