Evaluation of individual cognitive remediation therapy (CRT) for the treatment of young people with anorexia nervosa
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Research suggests that there are cognitive inefficiencies underlying Anorexia Nervosa (AN), with CRT showing promise in improving these inefficiencies in adults. This area has yet to be explored in a younger population. The aim of this study was to evaluate the use of CRT for young people.
A within-subjects design was used to compare the performance of children and adolescents with AN on several neuropsychological measures administered before and after a course of CRT.
Ninety-two female participants diagnosed with AN aged between 11 and 17 (M = 14.8, SD = 1.6), all receiving treatment at a specialist inpatient unit. The assessment consisted of the Rey–Osterrieth Complex Figure test (ROCFT), the Behaviour Rating Inventory of Executive Function–Self-Report (BRIEF-SR), and the D-KEFS Colour-Word Interference Test (CWT). Repeated-measures t tests were used to analyse the ROCFT and BRIEF-SR data. There was a significant improvement in Central Coherence Index (p < .001), Immediate Recall (p < .001), Shift (p < .001) Cognitive Shift (p = 002), Behavioural shift (p < .001), Emotional Control (p < .001), Working Memory (p = .001), Plan/Organize (p < .001), Monitor (p = .001) BRI (p < .001), MI (p = .001), and GEC (p < .001). On the D-KEFS CWT, a repeated-measure Wilcoxon signed-rank test revealed a significant improvement in Error Rate (p = .019) and a repeated-measures t test revealed a significant improvement in time taken (p < .001).
Results suggest that CRT for children and adolescents with AN could strengthen specific cognitive domains.
KeywordsCognitive remediation therapy Anorexia nervosa Central coherence Cognitive flexibility Executive functioning Treatment
The authors would like to thank Prof. Bryan Lask for introducing CRT in our service and the support and guidance he provided.
Compliance with ethical standards
Disclosure of potential conflicts of interest
All authors declare that they have no conflict of interest.
For this study, formal ethical approval is not required, as the therapy and assessments were a part of the standard treatment programme. The assessments were conducted to inform the content of the Cognitive Remediation Therapy sessions and to provide feedback to the patients.
Informed consent was obtained from all parents or guardians and individual participants included in the study at the admission.
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