Theory-driven assessment of cognitive flexibility in bulimia nervosa: a preliminary study

Background: Cognitive flexibility (CF) is defined as the ability to switch efficiently between different concepts or tasks. Empirical evidence of CF in individuals with bulimia nervosa (BN), offers conflicting conclusions, attributed to how CF is conceptualized and operationalized. The aims of the current study were to compare CF performance of women with BN to healthy controls, utilising a CF model that includes three subtypes termed: task switching, switching sets and stimulus-response mapping. In addition, to examine the association between CF subtypes and BN clinical characteristics. Methods: Sixty-two women (twenty-eight with BN and thirty-four healthy controls) with a mean age of 24.4, completed a CF cognitive battery. Performance was measured by response time and accuracy. Results: The BN group’s response time was worse only on task switching, but was significantly more accurate on stimulus-response mapping. There was no significant correlation between CF scores and BN clinical characteristics. Conclusions: Women with BN present with an impairment only on higher CF demands, whereas their performance at lower-level CF tends to be more accurate. Additionally, CF is independent of clinical characteristics, thus supporting evidence that it may reflect a trait nature in BN.