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Eating Disorders: “Out of Control?” by Claes et al.

Study summary

A study was carried out to investigate variations between restrictive and bingeing/ purging eating disorders. Claes et al. (2012) assessed the two types of inhibition, executive and reactive inhibition, using personality and neuropsychological examinations. Executive adaptations are top-down approaches that help a person gain control of their eating habits and include interference control, cognitive inhibition, and motor inhibition. Reactive behavioral mechanisms are bottom-up approaches that rely on disrupting existing behaviors whenever they arise due to fear of punishment.

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The hypothesis for the study was rooted in the understanding that cognitive and personality traits emanate from the same neurological systems. It was therefore expected that positive correlations would be witnessed between measures for the personality and mental traits in participants suffering from eating disorders (ED). Previous studies showed that the association between nature and cognitive measures was minimal. Other previous studies had witnessed negative correlations between these phenomena. Claes et al. (2012) incorporated both reactive and executive inhibition alongside both personality and cognitive tests, a feature absent in previous studies. The research targetted to fill a gap in the studies on eating disorders’ causes and characteristics using both tests and both varieties of EDs.

Participants and Setting

There were 48 female participants in the study, all admitted to an in-patient facility for eating disorders. All the participants consented to participate in the study, and it was approved satisfactorily. A questionnaire was used for data collection, and all the patients underwent the necessary cognitive tests in a test room. The study utilized the IntegNeuroTM software to assess executive inhibition on the cognitive level.

The Effortful Control Scale was used to measure executive control at the personality level. Reactive control was not assessed on the cognitive level, but the Behavioral Inhibition Activation System (BIAS) was used to measure reactive control at the personality level. Data analysis involved the use of MANOVA and MANCOVA, with the latter using current patient BMI as a covariate. Pearson correlation coefficient was used to calculate the associations between personality and cognitive traits in measuring executive and reactive eating disorders.


There was a significant difference between patients with restrictive ED from those with bingeing/purging behavior ED with a p=0.017. Lower levels of attention and motor inhibition control were observed in patients with bingeing /purging ED contrasted to those with restrictive ED. After controlling for current BMI, MANCOVA analysis discovered that executive inhibition in patients with bingeing/purging ED still reported lower attention levels with a p=0.009. Patients with bingeing/purging ED still had a slower mean concentration-time in the Trail Making Test after adjustments for BMI in MANCOVA.


Patients with bingeing/purging ED behaviors generally have more problems with executive control compared to their reactive counterparts. Bingeing/purging ED patients also demonstrated more behavioral inhibition compared to the restrictive ED patients. The impulsive behavior in bingeing/purging patients can be explained by their diminished psychological controls and scores. Minimal differences in the cognitive scores for patients with both types of EDs were significant in showing that the disorders did not emanate from intellectual deficiencies.

Implications in Real Life

A weakness of the study was its use of a small sample size which tampered with the generalizability of the study. Claes et al. (2012) recommend the use of larger samples in future similar studies that incorporate varied populations and genders. The study is essential in the development of treatment criteria for EDs as they are poised to focus on behavioral phenomena rather than cognitive treatments. The study has filled a crucial gap in the literature on EDs while encouraging the exploration of deficiencies in the study, such as a cognitive study of restrictive ED. This study is a crucial tool that is capable of forming a study element for people with ED to enable them to comprehend their situation better and regulate it appropriately.

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Claes, L., Mitchell, J. E., & Vandereycken, W. (2012). Out of control?: Inhibition processes in eating disorders from a personality and cognitive perspective. International Journal of Eating Disorders, 45(3), 407–414. Web.

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