Prospective associations among nonverbal reasoning abilities, illness duration, and eating disorder symptoms in anorexia nervosa and bulimia nervosa
Year: 2026
Type: article
Study design: Observational Study
Abstract: Individuals with eating disorders (EDs) often exhibit impairments in executive functioning, including nonverbal reasoning. However, little is known about how nonverbal reasoning interacts with illness duration, influences ED symptom changes over time, or differentially affects phenotypically distinct EDs. This study examined associations among nonverbal reasoning, illness duration, and changes in ED symptoms in individuals with anorexia nervosa (AN) and bulimia nervosa (BN). Adults with AN or BN (N = 83; mean age = 25.9) completed baseline assessments of ED symptoms, illness duration, nonverbal reasoning, height, weight, and anxiety and depressive symptoms. ED symptoms and weight were reassessed at 3 and 6 months after baseline. Linear regression analysis and multilevel modeling were used to evaluate associations between nonverbal reasoning, illness duration, and ED symptom trajectories. In the AN group, longer illness duration was significantly associated with poorer baseline nonverbal reasoning, even after adjusting for BMI. There was no significant association between illness duration and nonverbal reasoning in the BN group. Among individuals with BN, better baseline nonverbal reasoning predicted a greater reduction in ED symptoms over 6 months, while poorer baseline nonverbal reasoning was associated with no significant change in symptoms. In AN, nonverbal reasoning did not predict ED symptom change from baseline to follow-up. In AN, longer illness duration was linked to poorer nonverbal reasoning, whereas in BN, better nonverbal reasoning predicted improvement in symptoms over time. These findings support the relevance of nonverbal reasoning to AN and BN. Future longitudinal studies are needed to confirm the findings and gain additional insights into associations among nonverbal reasoning, illness duration, and ED symptoms. Many individuals with eating disorders (e.g., anorexia nervosa [AN] and bulimia nervosa [BN]) have a long course of illness, and existing treatments are ineffective for many people with AN and BN. Underlying factors that could help explain these outcomes are unclear. Growing evidence suggests that cognitive function (i.e., mental processes involved in gathering and processing information) may help clarify why eating disorders persist for some individuals. We tested whether nonverbal reasoning, or the ability to solve problems using visual information, is related to length of eating disorder illness and eating disorder symptoms in individuals with AN and BN over a 6-month period. A longer illness length was related to poorer nonverbal reasoning in AN but not BN. Poorer nonverbal reasoning was related to worse eating disorder symptoms over time in BN, but not AN. These results suggest that there may be a distinct link between a longer course of illness and nonverbal reasoning for individuals with AN. Results also suggest that nonverbal reasoning abilities may be important to address in treatment for BN because nonverbal reasoning may maintain symptoms over time for these individuals.
Source: Journal of Eating Disorders
Authors: Matthew F. Murray, Elizabeth N. Dougherty, Samantha E. Weiss, Jennifer E. Wildes
Institution: University of Chicago
Language: English
Subfield: Clinical Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: gold
Estimated APC paid: $2,190
OpenAlex ID: W7124146338