Cognitive Profile of Anorexia Nervosa: A Focus on Higher-Level Executive Functions and Visuospatial Processing

The present chapter will focus on the neuropsychology of anorexia nervosa, a severe and fascinating psychiatric disorder characterized by extreme weight loss and malnutrition, intense fear of gaining weight despite significant underweight, and a body image disturbance manifesting in an inability to realistically assess one’s body size (weight and shape). Beyond severe medical complications, which may involve all organs and systems, associated with weight loss, malnutrition, and other dysfunctional eating-purging behaviors, anorexia nervosa is also characterized by a significant cognitive alteration, particularly in executive functions and visuospatial processing. Cognitive dysfunction includes cognitive rigidity, poor decision-making, along with alterations in processing and integrating visual and spatial information, and may contribute to a rigid thinking pattern and the persistence of dysfunctional behaviors (i.e., restrictive eating, hyperactivity, and obsessive thoughts about body weight and shape), besides affecting psychological functioning and reducing the likelihood of recovery. By integrating current findings from neuropsychology and clinical practice, this chapter provides an extensive overview of the cognitive alterations associated with anorexia nervosa and their implications for treatment and recovery.