Spanish study results demonstrate that individuals with eating disorders may be worse decision-makers than those without such conditions.
However, the mechanism that underlies the impaired decision-making skills observed among these individuals differs with eating disorder type, say Ignasi Garrido and Susana Subirá, from Universitat Autònoma de Barcelona.
When 27 individuals with anorexia nervosa (AN) and 44 with bulimia nervosa (BN) were asked to carry out the Iowa Gambling Task (IGT; a decision-making card-based test), those with AN consistently chose disadvantageous card decks.
By contrast, healthy controls (n=38) quickly learned to avoid choosing card decks that led to a bad outcome.
Although BN individuals displayed significantly better decision-making skills than those with AN, they still showed an inability to consistently avoid choosing disadvantageous decks.
Healthy controls were significantly better at decision-making than both AN and BN patients.
"This real-life decision-making impairment reflects their inability to properly weight the costs and benefits of their decisions in the long-term, which could be one of the etiological factors for eating disorders," say the authors.
Of note, decision-making performance showed no significant association with disease severity variables, such as body mass index, age of eating disorder onset, and duration of illness.
The presence of depressive symptoms also showed no correlation with IGT score.
When the relationship between decision-making and impulsivity was assessed, impulsivity was found to be negatively associated with decision-making among BN and AN patients with a binge/purging subtype.
No association was found between the two factors among AN patients with a restricting subtype.
"The results suggest that there may be different factors underlying decision-making deficits in AN restricting type on one hand, and in AN binge/purging type and BN, on the other" say Garrido and Subirá in Psychiatry Research.
The authors conclude: "As decision-making impairment is probably involved in the etiopathogenesis and/or maintenance of eating disorders, it would be useful to develop treatment programs that are focused on improving decision-making abilities."
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