Abstract：
OBJECTIVE: 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.
METHODS: Ninety-two female patients with AN (mean age: 16.2, range: 13-21 years) completed neurocognitive tests (Rey Complex Figure Test, Adapted Version of the Wisconsin Card Sorting Test) before and after 12 months 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 18 months.
RESULTS: 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.
CONCLUSIONS: 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.
METHODS: Ninety-two female patients with AN (mean age: 16.2, range: 13-21 years) completed neurocognitive tests (Rey Complex Figure Test, Adapted Version of the Wisconsin Card Sorting Test) before and after 12 months 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 18 months.
RESULTS: 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.
CONCLUSIONS: 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.
摘要：
目的：我们旨在评估以神经性厌食症（AN）为主的青少年队列中集合迁移和中枢相干性的纵向变化，并探讨这些因素是否可以预测长期饮食失调的结局。
方法：92名患有AN的女性患者（平均年龄：16.2岁，范围：13-21岁）完成了神经认知测试（ReyComplexFigureTest，威斯康星州卡片分类测试的改编版）在12个月的心理治疗之前和之后（n=45MaudsleyAN治疗，曼陀罗；n=47标准心理治疗；非随机组）。在基线时评估进食障碍的严重程度，6、12和18个月后。
结果：在治疗过程中，中央一致性（由ReyFigureStyleIndex增加表示）和集合移位（由持续错误百分比降低表示）显着改善，各组结果相似。较低的中枢相干性与较高的进食障碍严重程度相关。从长期来看，基线移组能力较低的个体往往会有更糟糕的饮食失调结果。然而,这一趋势在多水平线性混合模型中没有达到统计学意义.
结论：青少年AN患者的神经认知障碍在治疗后可以得到改善。专门针对思维和行为灵活性的干预措施可能有助于治疗成功。
方法：92名患有AN的女性患者（平均年龄：16.2岁，范围：13-21岁）完成了神经认知测试（ReyComplexFigureTest，威斯康星州卡片分类测试的改编版）在12个月的心理治疗之前和之后（n=45MaudsleyAN治疗，曼陀罗；n=47标准心理治疗；非随机组）。在基线时评估进食障碍的严重程度，6、12和18个月后。
结果：在治疗过程中，中央一致性（由ReyFigureStyleIndex增加表示）和集合移位（由持续错误百分比降低表示）显着改善，各组结果相似。较低的中枢相干性与较高的进食障碍严重程度相关。从长期来看，基线移组能力较低的个体往往会有更糟糕的饮食失调结果。然而,这一趋势在多水平线性混合模型中没有达到统计学意义.
结论：青少年AN患者的神经认知障碍在治疗后可以得到改善。专门针对思维和行为灵活性的干预措施可能有助于治疗成功。
