Vitamin Supplementation in Anorexia Nervosa: Examining Executive Function in Relation to the Interaction of Vitamin Supplementation and Anorexic Status
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Anorexia nervosa (AN) has the highest mortality rate of psychological disorders and is characterized by food restriction, rigid and extreme weight loss behaviors, and altered self-perceptions (Hanachi et al., 2019). Cognitive deficits and nutritional deficiencies have been suggested to impact the progression of pathology and outcome of treatment in AN (Dahlgren et al., 2019; Hale & Logosimo, 2019). Investigations into the cognitive profile of AN have found evidence to suggest deficits in executive function (EF), particularly in domains of inhibitory control and cognitive flexibility (Smith et al., 2018). Though the precise effects of micronutrients on cognition have yet to be determined, vitamin supplementation has been examined in cognitive aging studies and is clinically used in the rehabilitation of AN (Cuerda et al., 2019). The goal of the current study was to identify differences in EF according to (a) the effect of AN status, (b) the effect of vitamin supplementation, and (c) the interaction of AN status and vitamin supplementation. Using a between-subjects design, 683 participants reported if they have a current or previous diagnosis of AN as well as vitamin supplementation habits via online survey. Participants also digitally completed the inhibition and set-shifting subscales of the Behavior Rating Inventory of Executive Function–Adult version (BRIEF-A; Roth et al., 2005), the Stroop Task (Stroop, 1935), and the Wisconsin Card Sorting Task (WCST; Grant & Berg, 1948). Results did not detect an effect of AN status, an effect of supplement status, or an interaction on the BRIEF-A inhibition subscale, performance on the Stroop Task, or performance on the WCST. A small-magnitude main effect of AN status was found for the BRIEF-A set-shifting subscale (p < .01), whereby anorexic individuals (M = 12.28, SD = .39) exhibited more daily-life problems with cognitive flexibility than healthy controls (M = 10.85, SD = .11). Moreover, a small-magnitude main effect of vitamin supplementation was found for the BRIEF-A set-shifting subscale (p = .03), whereby supplementing individuals (M = 11.15, SD = .20) exhibited less problems with cognitive flexibility in daily-life tasks than non-supplementing individuals (M = 11.98, SD = .34). Limitations and implications of my findings are discussed.