New Therapy Targets Neuropsychological Functioning

Cognitive remediation therapy targets severe or lasting eating disorders.

A new therapy based on neuropsychological functioning has recently been tested in patients with severe or lasting eating disorders. Scientists at the Center for Eating Disorders Ursala, Leidschendam, The Netherlands, treated 82 patients who were randomly assigned either to cognitive remediation therapy (CRT) plus intensive treatment as usual or to treatment as usual alone (Psychother Psychosom. 2014; 83:29).

CRT is a behavioral treatment that uses drill and practice, and compensatory and adaptive strategies to improve targeted cognitive areas like memory, attention, and problem-solving. Unlike the much better known cognitive behavior therapy (CBT), which teaches patients to think through emotionally challenging problems, CRT helps improve the underlying neuropsychological functions that aid thinking, attention, memory, planning, organization, and abstract thinking. For example, someone with attention and memory problems may have difficulty following directions from their boss, or may lose track of important information provided by their friends and family. Other persons who have difficulty being organized and prioritizing information may find it hard to manage independent living or going to school. CRT remediation is intended to help people who have experienced a decline in their cognitive skills, or who were unable to fully develop their skills because of illness. CRT often involves the use of a computer to provide exercises to improve neuropsychological skills.

Applying CRT to eating disorders

Dr. A.E. Dingemans reported on 82 patients with severe eating disorders who randomly received CRT plus treatment as usual (41 patients) or treatment as usual (41 patients). Cognitive measures (set-shifting and central coherence), eating disorder pathology, general psychopathology, motivation, quality of life, and self-esteem were all measured.

Participants were assessed at baseline, after 6 weeks of treatment, and finally 6 months after treatment ended. Those who had the combination therapy had significantly improved quality of life at the end of treatment, as well as fewer eating disorder symptoms, compared to those who had received treatment as usual. Patients with poor set-shifting abilities prior to treatment benefited more from CRT than did those without set-shifting deficits and their quality of life was also higher.