Background: Past research has indicated the presence of cognitive difficulties in individuals with anorexia nervosa (AN), although it is unclear how these are experienced in real life. Moreover, it is unclear how and whether the experience of cognitive difficulties changes in nature and intensity over the course of the illness and following recovery.
Methods: Twenty-one female participants (AN = 11; recovered AN = 10) participated in online semi-structured interviews, utilising open-ended questions and exploring topics relating to their experiences of their cognitive function, changes over time and their perspectives on the future. Reflexive thematic analysis was conducted on the resulting transcripts.
Results: Six themes were identified, centred around the effects of the illness on mental and physical function, cognition, adaptation to living with the illness, similarities between AN and other psychopathology, tentative optimism for the future and recovery as a representation of liberation. Whilst respondents with AN appeared to perform remarkably well in their professional and educational lives, the cognitive difficulties were described as significantly impacting their ability to engage in life, particularly in the context of leisure and socialising. Respondents recovered from AN noted the importance of developing a non-AN identity as well as better emotion-regulation skills as central to recovery.
Conclusions: Whilst people with AN may be able to adapt their lives to the demands of the illness, they report significant cognitive difficulties that interfere with their engagement in many aspects of daily life. This should be considered by professionals working in the clinical management of AN. Treatments focused on ameliorating cognitive difficulties, and promoting emotional regulation and identity in AN are warranted.
Keywords: Anorexia nervosa; Cognition; Interview; Qualitative; Recovery.
Individuals with anorexia nervosa (AN), an eating disorder associated with low weight, often experience poor quality of life and difficulties in thinking and brain function. In this study, 11 individuals with AN and 10 individuals recovered from AN were interviewed in order to explore the nature of these cognitive difficulties. Overall, respondents reported experiences of poor brain function, as well as similarities between AN and other psychiatric illnesses, and described how they adapted their lives around these experiences. They also were somewhat optimistic about the future, and respondents viewed feelings of liberation as a central aspect of recovery. Whilst individuals with AN often appear to be functioning very well, it appears that there are several difficulties associated with brain function and mood that may interfere with the ability to engage in daily life, especially in leisure and social activities.
© 2022. The Author(s).