Set-shifting, central coherence and decision-making in individuals recovered from anorexia nervosa: a systematic review

BACKGROUND: The aim of this study was to review the existing literature and evaluate whether deficits in set-shifting, central coherence and decision-making persist in individuals recovered from anorexia nervosa (AN-REC). METHOD: A systematic review approach was used. Literature was identified via searches in PubMed, PsychInfo and Embase database. The main search resulted in 158 articles. After exclusion of 135 articles, 23 articles were included in the review. RESULTS: The majority of studies on set-shifting showed that set-shifting difficulties persist after recovery. Central coherence might also be trait related, however findings are inconsistent. Few studies have investigated decision-making in AN-REC, however those studies that do exist suggest that decision-making is not impaired in AN-REC. CONCLUSIONS: Novel treatment strategies based on neuroscience research are emerging, focusing on targeting the underlying mechanisms of the illness, including neuropsychological functioning. Whether these functions are trait or state related could have implications for how they are targeted in treatment.