Resumo

CAMACHO RUIZ, Esteban Jaime; ESCOTO PONCE DE LEON, María del Consuelo  e  MANCILLA DIAZ, Juan Manuel. Neuropsychological evaluation in patients with eating disorders. Salud Ment [online]. 2008, vol.31, n.6, pp.441-446. ISSN 0185-3325.

Research related to neuropsychological evaluation on eating disorders (ED) has produced diverse results, being more abundant those which study attention, specifically using Stroop Test, both in the standard and the modified versions, using words related to food and body shape. In most of the cases, different clinical groups have not been used in the same research. Studies have not used other tests which evaluate cognitive areas besides those evaluated by Stroop Test; and most of researchers who have measured attention with Stroop Test have focused on measuring latency and not interference. Some studies have found deficits in attention, executive functions, and memory in patients with ED; however, other studies have not found deficits in attention. Because of this evidence, the present study proposed that patients with ED would show deficits in selective attention, perseverative thinking, working memory, and executive planning, compared to a control group without ED. Participants included 26 female patients with bulimia nervosa (BN) and 10 female patients with anorexia nervosa (AN), matched in age and education by the control group (n = 36). All patients met eating disorders criteria, and did not have a history of neuropsychological evaluation. Four neuropsychological tests were individually administered in two sessions with a counterbalanced approach: 1. Wisconsin Card Sorting Test, 2. Stroop Colors Test (developed in the program E-Prime with words related to food and body shape), 3. Rey-Osterrieth Complex Figure, and 4. Tower of London Test. There was a significant difference between three groups in the memory test, the execution total time and in the number of perseverative answers. In memory, the AN group had the worst performance, followed by the BN group. As for the executive planning, both AN and BN groups took longer to complete the test compared to the control group. Finally, AN and BN groups showed more perseverative answers than the control group. There was a statistically significant difference in the number of errors for negative words related to body shape. Post hoc indicated that AN and BN groups produced more errors than the control group, whereas BN group took longer to complete the negative word list related to body shape, in comparison to the control group. Results demonstrate a deficit in cognitive processing in AN and BN groups. The AN group showed a greater impairment in memory than BN group, in comparison to the control group; additionally, both groups of patients took longer to complete the Tower of London Test. This indicates the existence of problems of executive planning in these patients. What is more, in both groups of patients a greater perseverative thinking was observed; this indicates an impairment in the establishment of an appropriate strategy to solve problems, a characteristic of BN patients. Anorectic and bulimic patients showed an attentional deficit for words with negative valence related to body shape. In addition, the AN group showed an attentional bias both for words with positive valence and words with negative valence related to food, and the BN group produced more errors in the words with positive valence related to body shape. In this sense, it is proposed that the patients have general units of knowledge or <<schemes>> that determine what the most important aspects of a situation are and what sort of information will be stored and processed. From this perspective, body image alterations, and attentional, memory, and executive functions biases for stimuli related to food, shape, and weight represent different ways of information processing biases, because there is distortion in the way the patients perceive and interpret their experiences.

Palavras-chave : Eating disorders; cognitive assessment; working memory; problem solving.

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