Neuropsychological Aspects of Eating Disorders – A Focus on Diagnostic Criteria

Abstract

The interest in neurological basis for behavior has increased lately. Neuro-imaging techniques have made observations of human behavior possible in ways that were not anticipated a few decades ago. Eating disorders (ED) are severe psychiatric disturbances with psychosomatic complications, mainly affecting young women. The main diagnoses are anorexia nervosa (self-starvation) and bulimia nervosa (binge-eating and compensatory actions). Eating pathology has been linked to both neurological abnormalities and disturbances in neurotransmitters and neuroendocrine systems. It is not clear, however, whether these malfunctions are due to the condition or if they stand as predisposing factors. The Minnesota postwar experiment studied effects of starvation in a group of healthy men and showed behavioral patterns similar to those in patients with ED. Neuropsychological studies on ED patients show that cognitive functioning is impaired. Executive functions, visuospatial abilities, and psychomotor speed seem to be the main areas affected. Different regions of the brain are connected to food intake and could be involved in eating pathology. Hypothalamus and the insular cortex have been suggested to be of importance in ED. Further, reduced hippocampal volume and reductions in both grey and white matter has been reported in ED. These alterations are likely to be connected to deficits in cognitive functions, but seem to be reversible after recovery. Studies show that activation of the brains network for fear is involved in food processing and body distortion, indicating the severity of symptoms. The importance of assessing neurological structures and functions underlying the pathological eating behavior and related symptoms is essential for an increased understanding of these disorders. New insights in the interplay between brain and behavior make it possible to develop new methods for treatment and prevention in ED.