Abstract
Background: Individuals 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. Methods: Participants 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. Results: Lower 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. Conclusion: These 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.
Original language | English |
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Pages (from-to) | 2180-2191 |
Number of pages | 12 |
Journal | International Journal of Eating Disorders |
Volume | 54 |
Issue number | 12 |
Early online date | 30 Oct 2021 |
DOIs | |
Publication status | Published - Dec 2021 |
Bibliographical note
Funding Information:Mental Health Care Research Program Fellowship, Grant/Award Number: 636320005; Sophia Foundation for Scientific Research (SSWO), Grant/Award Number: S15‐13 Funding information
Funding Information:
The Erasmus Medical Center in Rotterdam has designed and conducted the Generation R Study in collaboration with the Erasmus School of Social and Behavioral Sciences of the Erasmus University Rotterdam, the Municipal Health Service Rotterdam, and the Stichting Trombosedienst & Artsenlaboratorium Rijnmond (STAR‐MDC), Rotterdam. The authors are thankful for the participation of the children and parents who took part in the study. The authors also thank general practitioners, hospitals, midwives, and pharmacies in Rotterdam for their contribution. The general design of Generation R Study is made possible by financial support from the Erasmus Medical Center, Rotterdam, the Erasmus University Rotterdam, ZonMw, the Netherlands Organization for Scientific Research (NWO), and the Ministry of Health, Welfare and Sport. For the current study, C.P.M.S. was supported by a grant from the Sophia Foundation for Scientific Research (SSWO) (Grant no. S15‐13). P.W.J. received a grant from the Netherlands Organization for Health Research and Development (Mental Health Care Research Program, Fellowship 636320005).
Funding Information:
The Erasmus Medical Center in Rotterdam has designed and conducted the Generation R Study in collaboration with the Erasmus School of Social and Behavioral Sciences of the Erasmus University Rotterdam, the Municipal Health Service Rotterdam, and the Stichting Trombosedienst & Artsenlaboratorium Rijnmond (STAR-MDC), Rotterdam. The authors are thankful for the participation of the children and parents who took part in the study. The authors also thank general practitioners, hospitals, midwives, and pharmacies in Rotterdam for their contribution. The general design of Generation R Study is made possible by financial support from the Erasmus Medical Center, Rotterdam, the Erasmus University Rotterdam, ZonMw, the Netherlands Organization for Scientific Research (NWO), and the Ministry of Health, Welfare and Sport. For the current study, C.P.M.S. was supported by a grant from the Sophia Foundation for Scientific Research (SSWO) (Grant no. S15-13). P.W.J. received a grant from the Netherlands Organization for Health Research and Development (Mental Health Care Research Program, Fellowship 636320005).
Publisher Copyright:
© 2021 The Authors. International Journal of Eating Disorders published by Wiley Periodicals LLC.