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©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
Self-reported and behavioural impulsivity in anorexia nervosa
Andrea Phillipou, Larry Allen Abel, David Jonathan Castle, Caroline Gurvich, Matthew Edward Hughes, Susan Lee Rossell
Andrea Phillipou, Larry Allen Abel, Department of Optometry and Vision Sciences, the University of Melbourne, Melbourne, VIC 3010, Australia
Andrea Phillipou, David Jonathan Castle, Department of Psychiatry, the University of Melbourne, Melbourne, VIC 3010, Australia
Andrea Phillipou, Department of Mental Health, the Austin Hospital, Melbourne, VIC 3084, Australia
Andrea Phillipou, David Jonathan Castle, Susan Lee Rossell, Department of Psychiatry, St Vincent’s Hospital, Melbourne, VIC 3065, Australia
David Jonathan Castle, Faculty of Health Sciences, Australian Catholic University, Melbourne, 3065 VIC, Australia
Caroline Gurvich, Susan Lee Rossell, Monash Alfred Psychiatry Research Centre, Melbourne, VIC 3004, Australia
Matthew Edward Hughes, Susan Lee Rossell, Brain and Psychological Sciences Research Centre, Swinburne University of Technology, Melbourne, VIC 3122, Australia
Author contributions: All the authors contribute to the manuscript.
Institutional review board statement: The study was granted independent ethics approval by the Human Research Ethics committees at St Vincent’s Hospital [(Human Research Ethics Committee A (HREC-A)] (057/12), Austin Health [(Non Drug Study Advisory Committee (NDSAC)] (H2012/04646) and The Melbourne Clinic [(The Melbourne Clinic Research Ethics Committee (TMC REC)] (235). In addition, the study received expedited ethics approval from Swinburne’s Human Research Ethics Committee (SUHREC) (2012/277) and was registered with The University of Melbourne Health Sciences Human Ethics Sub-Committee (HESC) (1239068), on the basis of the prior St Vincent’s Hospital review.
Informed consent statement: All participants gave written informed consent prior to study inclusion.
Conflict-of-interest statement: Phillipou A, Gurvich C, Hughes E and Rossell SL report no conflicts of interest; Abel LA reports personal fees from Actelion Pharmaceuticals, Switzerland, outside the submitted work; Castle DJ reports grants and personal fees from Eli Lilly, grants and personal fees from janssen-Cilag, Roche, Allergen, Bristol-Myer Squibb, Pfizer, Lundbeck, AstraZeneca and Hospira during the conduct of the study, outside the submitted work and personal fees from Eli Lilly, Bristol-Myer Squibb, Lundbeck, Janssen Cilag, Pfizer, Organon, Sanofi-Aventis, Wyeth, Hospira and Servier, outside the submitted work.
Data sharing statement: Technical appendix, statistical code, and dataset available from the lead author at ap@unimelb.edu.au. No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: David Jonathan Castle, MD, Professor of Psychiatry, Department of Psychiatry, St Vincent’s Hospital, Level 2, 46 Nicholson St, Fitzroy, 3065 VIC, Australia. david.castle@svha.org.au
Telephone: +61-3-92314751 Fax: +61-3-92314802
Received: April 19, 2016
Peer-review started: April 20, 2016
First decision: June 20, 2016
Revised: July 12, 2016
Accepted: August 11, 2016
Article in press: August 11, 2016
Published online: September 22, 2016
AIM
To examine how self-reported and behavioural impulsivity are related in anorexia nervosa (AN).
METHODS
Twenty-four females with AN and 25 healthy controls (HC) participant in the study. Self-reported impulsivity was assessed with the Barratt Impulsiveness Scale (BIS-11). The scale yields three second-order factors: Attentional, motor and non-planning. Behavioural impulsivity was investigated with the continuous performance test (CPT), a computer-based task of sustained attention in which numbers are flashed briefly on screen and participants are required to click the mouse when the same number appears consecutively. The rate of commission and omission errors can be used a measure of behavioural imulsivity.
RESULTS
AN participants self-reported increased attentional [AN: 20.67 (3.64), HC: 13.88 (2.91), P = 0.001] and reduced motor impulsivity [AN: 11.55 (2.28), HC: 14.08 (2.78), P = 0.002]. The rate of omission or commission errors on the CPT did not differ between groups (P > 0.05). BIS-11 and CPT measures did not significantly correlate, but attentional impulsivity was related to negative mood states in AN (depression: r = 0.52, P = 0.010, anxiety: r = 0.55, P = 0.006, stress: r = 0.57, P = 0.004).
CONCLUSION
The discrepancy between self-reported and behavioural impulsivity are discussed in terms of perfectionism in AN. Furthermore, it is suggested that improving negative mood states may resolve this inconsistency in AN.
Core tip: The findings of the study suggest a discrepancy between self-reported and behavioural impulsivity in anorexia nervosa (AN). Although AN patients did not demonstrate differences from healthy controls in behavioural impulsivity, they self-reported reduced motor impulsivity and greater attentional impulsivity. Attentional impulsivity was associated with negative mood states in AN, suggesting that improving these symptoms may improve patients’ perceptions of their attentional impulsivity.
