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Inhibitory Control in Bulimic-Type Eating Disorders: A Systematic Review and Meta-Analysis

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  • Mudan Wu
  • Mechthild Hartmann
  • Mandy Skunde
  • Wolfgang Herzog
  • Hans-Christoph Friederich

Abstract

The aim of this meta-analysis was to summarise data from neuropsychological studies on inhibitory control to general and disease-salient (i.e., food/eating, body/shape) stimuli in bulimic-type eating disorders (EDs). A systematic literature search was conducted to identify eligible experimental studies. The outcome measures studied included the performance on established inhibitory control tasks in bulimic-type EDs. Effect sizes (Hedges' g) were pooled using random-effects models. For inhibitory control to general stimuli, 24 studies were included with a total of 563 bulimic-type ED patients: 439 had bulimia nervosa (BN), 42 had anorexia nervosa of the binge/purge subtype (AN-b), and 82 had binge eating disorder (BED). With respect to inhibitory control to disease-salient stimuli, 12 studies were included, representing a total of 218 BN patients. A meta-analysis of these studies showed decreased inhibitory control to general stimuli in bulimic-type EDs (g = −0.32). Subgroup analysis revealed impairments with a large effect in the AN-b group (g = −0.91), impairments with a small effect in the BN group (g = −0.26), and a non-significant effect in the BED group (g = −0.16). Greater impairments in inhibitory control were observed in BN patients when confronted with disease-salient stimuli (food/eating: g = −0.67; body/shape: g = −0.61). In conclusion, bulimic-type EDs showed impairments in inhibitory control to general stimuli with a small effect size. There was a significantly larger impairment in inhibitory control to disease salient stimuli observed in BN patients, constituting a medium effect size.

Suggested Citation

  • Mudan Wu & Mechthild Hartmann & Mandy Skunde & Wolfgang Herzog & Hans-Christoph Friederich, 2013. "Inhibitory Control in Bulimic-Type Eating Disorders: A Systematic Review and Meta-Analysis," PLOS ONE, Public Library of Science, vol. 8(12), pages 1-13, December.
    • Handle: RePEc:plo:pone00:0083412
    DOI: 10.1371/journal.pone.0083412
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    References listed on IDEAS

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    1. Kate Tchanturia & Helen Davies & Marion Roberts & Amy Harrison & Michiko Nakazato & Ulrike Schmidt & Janet Treasure & Robin Morris, 2012. "Poor Cognitive Flexibility in Eating Disorders: Examining the Evidence using the Wisconsin Card Sorting Task," PLOS ONE, Public Library of Science, vol. 7(1), pages 1-5, January.
    2. David Moher & Alessandro Liberati & Jennifer Tetzlaff & Douglas G Altman & The PRISMA Group, 2009. "Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement," PLOS Medicine, Public Library of Science, vol. 6(7), pages 1-6, July.
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