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Evaluation ViewAttendees 6

Eating Disorders
Symposia

Symposium 126 - Thinking Outside the Box: Novel Directions in Research in Cognitive Flexibility in Eating Disorders

Sunday, November 17, 2024
10:30 AM – 12:00 PM EST
Location: Grand Ballroom E, Level 5, Downtown Marriott
CE: 1.5

Keywords: Feeding Problems, Cognitive Processes, Risk / Vulnerability Factors
Level of Familiarity: Basic
Recommended Readings: Miles, S., Gnatt, I., Phillipou, A., & Nedeljkovic, M. (2020). Cognitive flexibility in acute anorexia nervosa and after recovery: A systematic review. Clinical psychology review, 81, 101905.,   Smith, K. E., Mason, T. B., Johnson, J. S., Lavender, J. M., & Wonderlich, S. A. (2018). A systematic review of reviews of neurocognitive functioning in eating disorders: The state‐of‐the‐literature and future directions. International Journal of Eating Disorders, 51(8), 798-821.,  
Dougherty, E. N., Bottera, A. R., Forester, G., Schaefer, L. M., Forbes, E. E., & Wildes, J. E. (2024). Prospective associations between cognitive flexibility and eating disorder symptoms in anorexia nervosa and bulimia nervosa. Psychiatry Research, 332, 115717.
,   Duriez, P., Kaya Lefevre, H., Di Lodovico, L., Viltart, O., & Gorwood, P. (2021). Increased cognitive flexibility mediates the improvement of eating disorders symptoms, depressive symptoms and level of daily life functioning in patients with anorexia nervosa treated in specialised centres. European Eating Disorders Review, 29(4), 600-610.,  
Hagan, K. E., Christensen, K. A., & Forbush, K. T. (2020). A preliminary systematic review and meta-analysis of randomized-controlled trials of cognitive remediation therapy for anorexia nervosa. Eating Behaviors, 37, 101391.

Eating disorders are associated with significant cognitive and behavioral inflexibility that manifests in both disorder-specific (e.g., rigid calorie counting; inflexible beliefs about weight) and generalized (e.g., perfectionistic behavior; worry) domains. While existing evidence-based treatments for eating disorders attempt to increase flexibility to promote adaptive behavior, growing data suggest that those with high levels of rigidity and obsessionality may be at greater risk for poorer outcome. Further, existing attempts to characterize cognitive and behavioral inflexibility in eating disorders have been mixed in their findings and are mostly cross-sectional in nature, and initial attempts to target cognitive inflexibility within treatment using a neuropsychological framework have been disappointing. Conflicting results may be due to a number of factors, including few studies probing subcomponents of this process, lack of consideration of contextual influences on inflexibility, group-based comparisons that may obscure clinically-important heterogeneity in this process, and few studies that consider the role of cognitive (in)flexibility in treatment. Better probing cognitive flexibility in eating disorders through characterizing (a) subcomponents of this process and how they manifest, (b) dynamic interactions between cognitive inflexibility with eating disorder symptoms, and (c) how current treatments invoke or operate on cognitive flexibility will provide insights that can be used to inform subsequent treatment-related research.
Toward that end, the current symposium aims to highlight recent and ongoing research on cognitive flexibility across a range of eating disorder samples. Featured talks either characterize a subcomponent of cognitive flexibility with relevance to eating disorder treatment, test dynamic associations between aspects of cognitive inflexibility and eating disorder symptoms, explore associations between cognitive flexibility and treatment outcome, or probe meaningful heterogeneity in cognitive flexibility within eating disorder samples. Presentations feature clinical samples with a range of ages and developmental stages (i.e., adolescence through adulthood) and clinical presentations (i.e., bulimic-spectrum eating disorders and restrictive eating disorders). Our discussant, an expert in eating disorders treatment and neurocognition, will focus on emphasizing themes shared across talks and generate discussion regarding promising next steps in this line of work. Altogether, our symposium will offer insights for those who treat eating disorders in their clinical practice and those engaged in research and training on eating disorders, commonly co-occurring conditions, or cognitive flexibility more broadly. It will also offer an opportunity for a group of early-career, female researchers to showcase their innovative work focused on improving outcomes for those who suffer from eating disorders.

Learning Objectives:

At the end of this session, the learner will be able to:
  1. Describe common manifestations of cognitive inflexibility across eating disorder diagnoses
  2. Name common methods to evaluate cognitive flexibility in eating disorders and limitations of these methods
  3. Discuss several pathways through which cognitive flexibility may relate to eating disorder symptoms in real time
  4. Brainstorm several ways to address cognitive flexibility in treatment with patients who eating disorders
  5. Characterize past research focusing on cognitive flexibility in eating disorders and list several reasons for past mixed findings

Presentations:

  • 10:30 AM – 12:00 PM EST
    (SYM 126) Exploring Functional Relationships Between Uncertainty, Repetitive Negative Thinking, and Eating Disorder Risk Using Ecological Momentary Assessment

    Speaker: Erin E. Reilly, Ph.D. (she/her/hers) – University of California San Francisco

    Co-author: Zoe Stout, M.A. – Hofstra University

    Co-author: Ayla N. Gioia, M.A. – Hofstra University

    Co-author: Ashley Kwak, -- – Hofstra University

    Co-author: Clare Wieland, B.S. – Creighton University

    Co-author: Elisabeth Kac, - – Hofstra University

    Co-author: Sarah C. Dolan, M.A. – Hofstra University

    Co-author: Cate Morales, M.A. (she/her/hers) – Hofstra University

    Co-author: Kathryn Smith, Ph.D. – University of Southern California

  • 10:30 AM – 12:00 PM EST
    (SYM 126) Repetitive Negative Thinking Predicts Momentary Eating Disorder Behaviors Among Individuals with Eating Disorders

    Speaker: Margarita Sala, PhD (she/her/hers) – Ferkauf Graduate School of Psychology, Yeshiva University

    Co-author: Cheri Levinson, Ph.D. (she/her/hers) – University of Louisville

  • 10:30 AM – 12:00 PM EST
    (SYM 126) Identifying Distinct Latent Profiles of Executive Functioning Among Adolescents and Adults with Anorexia Nervosa and Adolescent Healthy Controls

    Speaker: Jiana Schnabel, B.S. (she/her/hers) – Temple University

    Co-author: Marita Cooper, Ph.D. (she/her/hers) – Children’s Hospital of Philadelphia

    Co-author: Sarah Peritz, M.A. – Children's Hospital of Philadelphia

    Co-author: Lauren Alloy, Ph.D. (she/her/hers) – Temple University

    Co-author: C.Alix Timko, PhD – Children's Hospital of Philadelphia

  • 10:30 AM – 12:00 PM EST
    (SYM 126) Different Assessments of Cognitive Flexibility Uniquely Predict Eating Disorder Treatment Outcomes in Adolescent Bulimia Nervosa

    Speaker: Simar Singh, Ph.D. (she/her/hers) – University of California San Francisco

    Co-author: Sasha Gorrell, Ph.D. – University of California San Francisco

    Co-author: Brittany Matheson, PhD – Stanford University

    Co-author: Erin E. Reilly, Ph.D. (she/her/hers) – University of California San Francisco

    Co-author: Jim Lock, MD/PhD – Stanford University

    Co-author: Daniel Le Grange, PhD – University of California, San Francisco

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