Neuro- and social-cognitive clustering highlights distinct profiles in adults with anorexia nervosa

Bethany Renwick; Peter Musiat; Anna Lose; Hannah Dejong; Hannah Broadbent; Martha Kenyon; Rachel Loomes; Charlotte Watson; Shreena Ghelani; Lucy Serpell; Lorna Richards; Eric Johnson-Sabine; Nicky Boughton; Janet Treasure; Ulrike Schmidt

doi:10.1002/eat.22366

Neuro- and social-cognitive clustering highlights distinct profiles in adults with anorexia nervosa

Bethany Renwick, Peter Musiat, Anna Lose, Hannah Dejong, Hannah Broadbent, Martha Kenyon, Rachel Loomes, Charlotte Watson, Shreena Ghelani, Lucy Serpell, Lorna Richards, Eric Johnson-Sabine, Nicky Boughton, Janet Treasure, Ulrike Schmidt

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Abstract

OBJECTIVE: This study aimed to explore the neuro- and social-cognitive profile of a consecutive series of adult outpatients with anorexia nervosa (AN) when compared with widely available age and gender matched historical control data. The relationship between performance profiles, clinical characteristics, service utilization, and treatment adherence was also investigated.

METHOD: Consecutively recruited outpatients with a broad diagnosis of AN (restricting subtype AN-R: n = 44, binge-purge subtype AN-BP: n = 33 or Eating Disorder Not Otherwise Specified-AN subtype EDNOS-AN: n = 23) completed a comprehensive set of neurocognitive (set-shifting, central coherence) and social-cognitive measures (Emotional Theory of Mind). Data were subjected to hierarchical cluster analysis and a discriminant function analysis.

RESULTS: Three separate, meaningful clusters emerged. Cluster 1 (n = 45) showed overall average to high average neuro- and social- cognitive performance, Cluster 2 (n = 38) showed mixed performance characterized by distinct strengths and weaknesses, and Cluster 3 (n = 17) showed poor overall performance (Autism Spectrum disorder (ASD) like cluster). The three clusters did not differ in terms of eating disorder symptoms, comorbid features or service utilization and treatment adherence. A discriminant function analysis confirmed that the clusters were best characterized by performance in perseveration and set-shifting measures.

DISCUSSION: The findings suggest that considerable neuro- and social-cognitive heterogeneity exists in patients with AN, with a subset showing ASD-like features. The value of this method of profiling in predicting longer term patient outcomes and in guiding development of etiologically targeted treatments remains to be seen.

Original language	English
Pages (from-to)	26-34
Number of pages	9
Journal	The International journal of eating disorders
Volume	48
Issue number	1
Early online date	3 Nov 2014
DOIs	https://doi.org/10.1002/eat.22366
Publication status	Published - 1 Jan 2015

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Renwick, B., Musiat, P., Lose, A., Dejong, H., Broadbent, H., Kenyon, M., Loomes, R., Watson, C., Ghelani, S., Serpell, L., Richards, L., Johnson-Sabine, E., Boughton, N., Treasure, J., & Schmidt, U. (2015). Neuro- and social-cognitive clustering highlights distinct profiles in adults with anorexia nervosa. The International journal of eating disorders, 48(1), 26-34. https://doi.org/10.1002/eat.22366

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title = "Neuro- and social-cognitive clustering highlights distinct profiles in adults with anorexia nervosa",

abstract = "OBJECTIVE: This study aimed to explore the neuro- and social-cognitive profile of a consecutive series of adult outpatients with anorexia nervosa (AN) when compared with widely available age and gender matched historical control data. The relationship between performance profiles, clinical characteristics, service utilization, and treatment adherence was also investigated.METHOD: Consecutively recruited outpatients with a broad diagnosis of AN (restricting subtype AN-R: n = 44, binge-purge subtype AN-BP: n = 33 or Eating Disorder Not Otherwise Specified-AN subtype EDNOS-AN: n = 23) completed a comprehensive set of neurocognitive (set-shifting, central coherence) and social-cognitive measures (Emotional Theory of Mind). Data were subjected to hierarchical cluster analysis and a discriminant function analysis.RESULTS: Three separate, meaningful clusters emerged. Cluster 1 (n = 45) showed overall average to high average neuro- and social- cognitive performance, Cluster 2 (n = 38) showed mixed performance characterized by distinct strengths and weaknesses, and Cluster 3 (n = 17) showed poor overall performance (Autism Spectrum disorder (ASD) like cluster). The three clusters did not differ in terms of eating disorder symptoms, comorbid features or service utilization and treatment adherence. A discriminant function analysis confirmed that the clusters were best characterized by performance in perseveration and set-shifting measures.DISCUSSION: The findings suggest that considerable neuro- and social-cognitive heterogeneity exists in patients with AN, with a subset showing ASD-like features. The value of this method of profiling in predicting longer term patient outcomes and in guiding development of etiologically targeted treatments remains to be seen.",

author = "Bethany Renwick and Peter Musiat and Anna Lose and Hannah Dejong and Hannah Broadbent and Martha Kenyon and Rachel Loomes and Charlotte Watson and Shreena Ghelani and Lucy Serpell and Lorna Richards and Eric Johnson-Sabine and Nicky Boughton and Janet Treasure and Ulrike Schmidt",

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Renwick, B , Musiat, P , Lose, A , Dejong, H , Broadbent, H , Kenyon, M, Loomes, R, Watson, C, Ghelani, S, Serpell, L, Richards, L, Johnson-Sabine, E, Boughton, N, Treasure, J & Schmidt, U 2015, 'Neuro- and social-cognitive clustering highlights distinct profiles in adults with anorexia nervosa', The International journal of eating disorders, vol. 48, no. 1, pp. 26-34. https://doi.org/10.1002/eat.22366

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T1 - Neuro- and social-cognitive clustering highlights distinct profiles in adults with anorexia nervosa

AU - Renwick, Bethany

AU - Musiat, Peter

AU - Lose, Anna

AU - Dejong, Hannah

AU - Broadbent, Hannah

AU - Kenyon, Martha

AU - Loomes, Rachel

AU - Watson, Charlotte

AU - Ghelani, Shreena

AU - Serpell, Lucy

AU - Richards, Lorna

AU - Johnson-Sabine, Eric

AU - Boughton, Nicky

AU - Treasure, Janet

AU - Schmidt, Ulrike

PY - 2015/1/1

Y1 - 2015/1/1

N2 - OBJECTIVE: This study aimed to explore the neuro- and social-cognitive profile of a consecutive series of adult outpatients with anorexia nervosa (AN) when compared with widely available age and gender matched historical control data. The relationship between performance profiles, clinical characteristics, service utilization, and treatment adherence was also investigated.METHOD: Consecutively recruited outpatients with a broad diagnosis of AN (restricting subtype AN-R: n = 44, binge-purge subtype AN-BP: n = 33 or Eating Disorder Not Otherwise Specified-AN subtype EDNOS-AN: n = 23) completed a comprehensive set of neurocognitive (set-shifting, central coherence) and social-cognitive measures (Emotional Theory of Mind). Data were subjected to hierarchical cluster analysis and a discriminant function analysis.RESULTS: Three separate, meaningful clusters emerged. Cluster 1 (n = 45) showed overall average to high average neuro- and social- cognitive performance, Cluster 2 (n = 38) showed mixed performance characterized by distinct strengths and weaknesses, and Cluster 3 (n = 17) showed poor overall performance (Autism Spectrum disorder (ASD) like cluster). The three clusters did not differ in terms of eating disorder symptoms, comorbid features or service utilization and treatment adherence. A discriminant function analysis confirmed that the clusters were best characterized by performance in perseveration and set-shifting measures.DISCUSSION: The findings suggest that considerable neuro- and social-cognitive heterogeneity exists in patients with AN, with a subset showing ASD-like features. The value of this method of profiling in predicting longer term patient outcomes and in guiding development of etiologically targeted treatments remains to be seen.

AB - OBJECTIVE: This study aimed to explore the neuro- and social-cognitive profile of a consecutive series of adult outpatients with anorexia nervosa (AN) when compared with widely available age and gender matched historical control data. The relationship between performance profiles, clinical characteristics, service utilization, and treatment adherence was also investigated.METHOD: Consecutively recruited outpatients with a broad diagnosis of AN (restricting subtype AN-R: n = 44, binge-purge subtype AN-BP: n = 33 or Eating Disorder Not Otherwise Specified-AN subtype EDNOS-AN: n = 23) completed a comprehensive set of neurocognitive (set-shifting, central coherence) and social-cognitive measures (Emotional Theory of Mind). Data were subjected to hierarchical cluster analysis and a discriminant function analysis.RESULTS: Three separate, meaningful clusters emerged. Cluster 1 (n = 45) showed overall average to high average neuro- and social- cognitive performance, Cluster 2 (n = 38) showed mixed performance characterized by distinct strengths and weaknesses, and Cluster 3 (n = 17) showed poor overall performance (Autism Spectrum disorder (ASD) like cluster). The three clusters did not differ in terms of eating disorder symptoms, comorbid features or service utilization and treatment adherence. A discriminant function analysis confirmed that the clusters were best characterized by performance in perseveration and set-shifting measures.DISCUSSION: The findings suggest that considerable neuro- and social-cognitive heterogeneity exists in patients with AN, with a subset showing ASD-like features. The value of this method of profiling in predicting longer term patient outcomes and in guiding development of etiologically targeted treatments remains to be seen.

U2 - 10.1002/eat.22366

DO - 10.1002/eat.22366

M3 - Article

C2 - 25363476

SN - 1098-108X

VL - 48

SP - 26

EP - 34

JO - The International journal of eating disorders

JF - The International journal of eating disorders

IS - 1

ER -

Neuro- and social-cognitive clustering highlights distinct profiles in adults with anorexia nervosa

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