عملکرد اجرای شاخص عملکرد اجرایی (EFI) و عوامل ریسک برای اختلال در غذا خوردن

We examined Executive Function Index (EFI) performance in individuals at risk (n = 22) for an eating disorder, based on the SCANS criteria. In comparison to those not at risk (n = 104; also based on the SCANS criteria), those at risk on SCANS were more likely to be depressed, anxious, and showed deficits in many components of EFI performance, including EFI impulse control and EFI total score. These results support previous work on executive function in those at risk for an eating disorder and highlight the use of the EFI as a tool for such investigation in this population.

In 2010, Scherr, Ferraro, and Weatherly showed that women at-risk for an eating disorder (based on the SCANS; Setting Conditions for Anorexia Nervosa Scale; Slade & Dewey, 1986) were more depressed, had lower motivation, displayed more empathy, were more anxious and had greater impulse behavior of urgency, as compared to women not at risk (Scherr, Ferraro & Weatherly, 2010). At-risk was defined as obtaining, on the SCANS, a dissatisfaction score greater than 42 and a perfectionism score greater than 22. Not at risk was defined as scoring at or below 42 and 22 on dissatisfaction and perfectionism (Slade & Dewey, 1986). While our at-risk subjects displayed higher urgency, which is consistent with greater impulse behavior, they did not show lower EFI impulse control or lower overall EFI total score performance. Impulsivity is associated with eating disorders (Wade & Wilsdon, 2005). Specifically, deficits in executive functioning have been found to be related to impulsivity or mental flexibility (Cooper and Fairburn, 1992, Fassino et al., 2002, Green et al., 1996 and Tchanturia, Anderluh, et al., 2004 and Tchanturia, Morris, et al., 2004). People with anorexia nervosa are often less flexible when it comes to change. This lack of flexibility and resistance to change has been found to often effect the treatment and the recovery process of the patient (Tchanturia, Anderluh, et al., 2004). Thus, we should see differences between at-risk and non-at-risk subjects on the impulse control subtest of the EFI (Spinella, 2005). The EFI is a 27-item self-report measure of executive functioning with good internal consistency (α = .82) and good convergent validity. It contains 5 subscales that were used to assess specific aspects of participants' executive functioning: Motivational Drive (MD), Impulse Control (IC), Empathy (EM), Organization (ORG) and Strategic Planning (SP), plus a total score. The EFI has demonstrated good internal consistency (α = .82) and the subscales evidenced adequate reliability (α = .55 to .74; Spinella, 2005). We again employed the SCANS as a way to identify individuals at risk for an eating disorder. It shows good validity and reliability (Butler, Newton, & Slade, 1988) and has been used recently to examine the relationship between family functioning and risk for an eating disorder (Felker and Stivers, 1994 and Lyke and Matsen, 2013). In the present study we wanted to revisit what impact being at-risk (or not) for an eating disorder has on executive function, as measured using the EFI. As in Scherr et al. (2010), we defined being at-risk as scoring greater than 42 on the Dissatisfaction (D) subscale of the SCANS and greater than 22 on the Perfectionism (P) subscale, as outlined in the original Slade and Dewey (1986) article. We defined not being at-risk with a more relaxed SCANS scoring method in which subjects could score greater than 42 on D and less than 22 on P (High D/Low P), lower than 42 on D and higher than 22 on P (Low D/High P), or lower than 42 on D and lower than 22 on P (Low D/Low P). This classification method increases our number of non-at-risk individuals, as compared to Scherr et al. (2010) from 21 to 104. Although our at-risk sample in the present study is 22 (was 41 in Scherr et al.), the addition of non-at-risk subjects increases our power of finding group differences. We expect to replicate Scherr et al. (2010) with the added prediction that at-risk subjects will also show deficits on EFI impulse control and EFI total score.