Autobiographical memory following weight gain in adult patients with Anorexia Nervosa: A longitudinal study.

COMPETENCY assessment (Law); ANOREXIA nervosa complications; CROSS-sectional method; BULIMIA; BODY mass index; PROMPTS (Psychology); LEANNESS; RESEARCH funding; INTERVIEWING; BODY weight; EMOTIONS; PROBLEM solving; DESCRIPTIVE statistics; AUTOBIOGRAPHICAL memory; LONGITUDINAL method; RESEARCH methodology; ANALYSIS of variance; DISEASE relapse; COMPARATIVE studies; WEIGHT gain; MENTAL depression; SELF-perception; ADULTS

Background: Patients with anorexia nervosa (AN) show overgeneralization of memory (OGM) when generating autobiographical episodes related to food and body shape. These memories are central for the construction of a coherent self‐concept, interpersonal relationships, and problem‐solving abilities. The current study aims to investigate changes in autobiographical memory following weight gain. Methods: OGM was assessed with an adapted version of the Autobiographical Memory Test including food‐, body‐, depression‐related, and neutral cues. N = 41 female patients with AN (28 restricting‐, 13 binge‐eating/purging‐subtype; mean disease duration: 4.5 years; mean BMI: 14.5 kg/m2) and N = 27 healthy controls (HC) were included at baseline. After inpatient treatment (mean duration: 11 weeks), 24 patients with AN and 24 age‐matched HC were reassessed. Group differences were assessed using independent samples t‐tests for cross‐sectional comparisons and repeated measures ANOVAs for longitudinal data. Results: At baseline, patients with AN generated significantly fewer specific memories than HC, independent of word category (F(1.66) = 27.167, p < 0.001). During inpatient stay, the average weight gain of patients with AN was 3.1 body mass index points. At follow‐up, patients with AN showed a significant improvement in the number of specific memories for both depression‐related and neutral cues, but not for food‐ and body‐related cues. Conclusions: Generalised OGM (i.e., independent of word category) in patients with AN before weight restoration may be a general incapacity to recall autobiographical memory. After weight gain, the previously well‐studied pattern of eating disorder‐related OGM emerges. The clinical relevance of the continuing disorder‐related OGM in patients with AN after weight gain is discussed. Highlights: 'Overgeneral Memory' (OGM) in severely underweight patients (mean body mass index = 14.5 kg/m2) with anorexia nervosa (AN) might be a state marker in the form of a general incapacity to recall autobiographical memories, regardless of emotional valence.Reduced symptoms of depression in patients with AN after weight gain, compared with the beginning of inpatient treatment, may be an indication of an overall improvement in mental health as negative memories become more specific.The persisting eating disorder‐related OGM after weight gain might be a maintaining factor of AN facilitating relapse and could also reflect increased dysfunctional emotion processing despite decreased eating disorder symptoms: functional avoidance might be a protective mechanism in the form of less confrontation with eating disorder‐related content through generalised memories. [ABSTRACT FROM AUTHOR]

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