The Influence of Negative Affect and Food Stimuli on Cognitive Flexibility in Adolescents With Anorexia Nervosa

Objective: Inflexible thinking among individuals with anorexia nervosa (AN) was proposed to reflect difficulties in set-shifting. However, studies assessing set-shifting in AN often find mixed results, especially in adolescent samples. It has been proposed that affective states and exposure to disorder-salient stimuli may modulate executive functions in AN. The current study examined the influence of induced negative emotion on the ability to shift toward or away from a food categorisation task among adolescents with AN. Methods: The study included 47 adolescents with AN and 41 healthy adolescents who performed a modified task-switching paradigm. Results: No indication of general set-shifting difficulties among adolescents with AN was found. Nevertheless, the results showed that when negative emotion was induced, adolescents with AN shifted from a non-food categorisation task to a food categorisation task with greater efficiency compared to a neutral emotion condition. Emotion and switch type did not influence set-shifting abilities among healthy adolescents. Conclusion: The findings indicate automatic and more efficient switching towards preoccupation with food among adolescents with AN while experiencing negative emotion. The results emphasise the important role played by situational factors in modulating cognitive abilities in individuals with AN.