Intact general and food-specific task-switching abilities in bulimia-spectrum eating disorders

Objective: Prior work evaluating cognitive flexibility (i.e., the ability to alter behavior in response to environmental changes) in bulimia-spectrum eating disorders (BN-ED) has produced mixed findings, perhaps due to reliance on set-shifting paradigms that do not effectively isolate cognitive flexibility. Task-switching paradigms are more precise, but no study has examined task-switching in BN-ED. Further, no study has examined whether cognitive flexibility deficits in BN-ED are disorder-specific (e.g., confined to food-related responses). Thus, the present study re-evaluated cognitive flexibility in BN-ED using general and food-specific task-switching paradigms.

Method: Individuals with BN-ED (n = 28) and healthy controls (HC; n = 39) completed a cued color-shape switching task (CCSST) and a novel food-specific variation (FCCSST). We compared BN-ED and HC on switch costs (reflective of transient task-switching) and mix costs (reflective of maintenance of switching behavior).

Results: Switch and mix costs were not significantly different between BN-ED and HC in terms of either accuracy or reaction time on the CCSST or FCCSST.

Conclusions: Findings suggest neither general nor food-specific cognitive flexibility is impaired in BN-ED. Rigidity in BN-ED (e.g., continued engagement in compensatory behaviors despite psychoeducation that these behaviors are ineffective for weight loss) may be a result of other neurocognitive impairments rather than cognitive flexibility deficits.