Set-shifting ability across the spectrum of eating disorders and in overweight and obesity: a systematic review and meta-analysis
饮食失调以及超重和肥胖的集合转移能力：系统评价和荟萃分析

Background. In this meta-analysis we review the findings from neuropsychological studies on set-shifting in people with eating disorders (EDs) or overweight/obesity.
背景。在这项荟萃分析中，我们回顾了神经心理学研究关于饮食失调 （EDs） 或超重/肥胖患者布景转移的结果。

Method. Four databases (PubMed, PsycINFO, PSYNDEX and Web of Science) were searched for eligible studies. Effect sizes (ESs) were pooled using random-effects models. Moderator analyses were conducted for ED and overweight/obese subgroups, adult/adolescent samples and measures of set-shifting.
方法。检索了四个数据库（PubMed、PsycINFO、PSYNDEX 和 Web of Science）以查找符合条件的研究。使用随机效应模型合并效应大小 （ES）。对 ED 和超重/肥胖亚组、成人/青少年样本和布景偏移测量进行调节器分析。

Results. Sixty-four studies with a total of 1825 ED patients [ 1394 anorexia nervosa (AN), 376 bulimia nervosa (BN) and 55 binge eating disorder (BED)] and 10 studies with a total of 449 overweight/obese individuals were included. The metaanalysis revealed a small to medium ES for inefficient set-shifting across all three ED diagnoses (Hedges’ $g=-0.45$$g=-0.45$g=-0.45g=-0.45 ). Subgroup analyses yielded small to medium ESs for each ED subtype ( $g=-0.44$$g=-0.44$g=-0.44g=-0.44 for AN, -0.53 for BED, -0.50 for BN), which did not differ significantly. There was a medium ES for restricting type AN (ANR; $g=-0.51$$g=-0.51$g=-0.51g=-0.51 ) but no significant ES for binge/purge type AN (AN/BP; $g=-0.18$$g=-0.18$g=-0.18g=-0.18 ). A medium ES was found across obesity studies $(g=-0.61)$$(g=-0.61)$(g=-0.61)(g=-0.61). The ES across overweight studies was not significant $(g=-0.07)$$(g=-0.07)$(g=-0.07)(g=-0.07). Adult samples did not differ from adolescent samples in either ED or overweight/obesity studies. The different set-shifting measures were associated with largely varying ESs.
结果。共纳入 64 项研究，共 1825 名 ED 患者 [1394 名神经性厌食症 （AN）、376 名神经性贪食症 （BN） 和 55 名暴食症 （BED）] 和 10 项研究，共 449 名超重/肥胖个体。荟萃分析显示，在所有三种 ED 诊断中，低效的 ES 都是无效的 ES （Hedges' $g=-0.45$$g=-0.45$g=-0.45g=-0.45 ）。亚组分析产生了每种 ED 亚型 （ $g=-0.44$$g=-0.44$g=-0.44g=-0.44 AN，BED 为 -0.53，BN 为 -0.50） 的中小型 ES，差异不显著。有一个中等 ES 用于限制 AN 型 （ANR; $g=-0.51$$g=-0.51$g=-0.51g=-0.51 ），但暴饮暴食/清除型 AN （AN/BP; $g=-0.18$$g=-0.18$g=-0.18g=-0.18 ）。在肥胖研究中 $(g=-0.61)$$(g=-0.61)$(g=-0.61)(g=-0.61) 发现了中等 ES。超重研究的 ES 不显著 $(g=-0.07)$$(g=-0.07)$(g=-0.07)(g=-0.07) 。在 ED 或超重/肥胖研究中，成人样本与青少年样本没有差异。不同的集合移动测量与很大差异的 ES 相关。

Conclusions. The meta-analysis provides strong support that inefficient set-shifting is a salient neuropsychological phenomenon across ED subtypes and obesity, but is less prominent in AN/BP and overweight. Compulsivity seems to be a common underlying factor supporting a dimensional and transdiagnostic conceptualization of EDs and obesity.
结论。荟萃分析提供了强有力的支持，即低效的移位是 ED 亚型和肥胖中一个突出的神经心理学现象，但在 AN/BP 和超重中不太突出。强迫性似乎是支持 ED 和肥胖的维度和跨诊断概念化的常见潜在因素。

Received 8 July 2013; Revised 29 January 2014; Accepted 29 January 2014; First published online 26 February 2014
2013 年 7 月 8 日接收;2014 年 1 月 29 日修订;2014 年 1 月 29 日接受;首次在线发布 2014 年 2 月 26 日
Key words: Anorexia nervosa, binge eating disorder, bulimia nervosa, cognitive flexibility, compulsivity, eating disorders, obesity, overweight, set-shifting.
关键词 ： 神经性厌食症， 暴食症， 神经性贪食症， 认知灵活性， 强迫症， 饮食失调， 肥胖， 超重， 移位。

Eating disorders (EDs), that is anorexia nervosa (AN), bulimia nervosa (BN) and binge eating disorder (BED), are common mental disorders with heightened morbidity and all-cause mortality (Treasure et al. 2010). Whereas AN patients of the restricting type (ANR) merely show severe food restriction, those of the binge/purge type (AN/BP) also show binge eating episodes and purging behaviours (e.g. self-induced vomiting or laxative misuse). Similarly, both BN and BED are characterized by recurrent episodes of binge eating with (BN) and without (BED) compensatory purging behaviours (APA, 2013).
饮食失调 （ED），即神经性厌食症 （AN）、神经性贪食症 （BN） 和暴食症 （BED），是常见的精神障碍，发病率和全因死亡率较高（Treasure 等人，2010 年）。限制型 （ANR） 的 AN 患者仅表现出严重的食物限制，而暴饮暴食/清除型 （AN/BP） 的患者也表现出暴饮暴食发作和清除行为（例如 自我诱导呕吐或滥用泻药）。同样，BN 和 BED 的特征都是反复出现暴饮暴食，有 （BN） 和没有 （BED） 补偿性清除行为 （APA， 2013）。

Obesity is defined as having a body mass index (BMI) $⩾30\mathrm{kg}/{\mathrm{m}}^2$$⩾30\mathrm{kg}/{\mathrm{m}}^2$>= 30kg//m^(2)\geqslant 30 \mathrm{~kg} / \mathrm{m}^{2}; overweight refers to a BMI between 25 and $30\mathrm{kg}/{\mathrm{m}}^2$$30\mathrm{kg}/{\mathrm{m}}^2$30kg//m^(2)30 \mathrm{~kg} / \mathrm{m}^{2}. Both conditions are multifactorial and mostly chronic and play important roles in the development of several somatic diseases such as diabetes, hypertension, cardiovascular disease and different types of cancer (Baumgartner et al. 1995; Pi-Sunyer, 2002). The prevalence of obesity has risen dramatically over the past 20 years and is considered as one of the most urgent public health concerns (WHO, 2000).
肥胖被定义为体重指数 （BMI） $⩾30\mathrm{kg}/{\mathrm{m}}^2$$⩾30\mathrm{kg}/{\mathrm{m}}^2$>= 30kg//m^(2)\geqslant 30 \mathrm{~kg} / \mathrm{m}^{2} ;超重是指 BMI 在 25 到 $30\mathrm{kg}/{\mathrm{m}}^2$$30\mathrm{kg}/{\mathrm{m}}^2$30kg//m^(2)30 \mathrm{~kg} / \mathrm{m}^{2} 之间。这两种疾病都是多因素的，而且大多是慢性的，在糖尿病、高血压、心血管疾病和不同类型癌症等几种躯体疾病的发展中起着重要作用（Baumgartner 等人，1995 年;Pi-Sunyer，2002 年）。肥胖症的患病率在过去 20 年中急剧上升，被认为是最紧迫的公共卫生问题之一（WHO，2000 年）。

Individuals with a bulimic-type ED (especially BN and BED) and those suffering from overweight or obesity share common behavioural patterns of compulsive overeating (Hill, 2007; Goldschmidt et al. 2008), neurobiological features of dysfunctional cognitive control and food addiction (Van den Eynde & Treasure, 2009; Volkow et al. 2012), in addition to biological and environmental risk factors (Bulik et al. 2003; Haines et al. 2010). Furthermore, co-morbidity rates are high between EDs and obesity (Villarejo et al. 2012).
患有暴食型 ED（尤其是 BN 和 BED）的人和超重或肥胖的人都有强迫性暴饮暴食的常见行为模式（Hill，2007 年;Goldschmidt等人，2008年），认知控制功能障碍和食物成瘾的神经生物学特征（Van den Eynde & Treasure，2009年;Volkow 等人，2012 年），除了生物和环境风险因素（Bulik 等人，2003 年;Haines 等人，2010 年）。此外，ED 和肥胖之间的合并率很高（Villarejo 等人，2012 年）。

Importantly, there is growing evidence for a link between obesity and inefficient cognitive control (Fitzpatrick et al. 2013). Given these similarities, bulimic-type EDs and obesity have been considered to lie on the same continuum (Williamson et al. 2002).
重要的是，越来越多的证据表明肥胖与低效的认知控制之间存在联系（Fitzpatrick 等人，2013 年）。鉴于这些相似性，暴食型 ED 和肥胖被认为位于同一连续体上（Williamson 等人，2002 年）。

Correspondingly, dimensional concepts and transdiagnostic theories on common mechanisms underlying the whole spectrum of EDs, including obesity, have gained increasing interest in recent years (Fairburn et al. 2003). Indeed, ED patients regularly show a diagnostic cross-over between ED categories and there is considerable co-morbidity between EDs and obesity, which supports a diagnostic approach based on dimensions of observable behaviour and neuropsychological measures (Eddy et al. 2008; Castellini et al. 2011; Monteleone et al. 2011). Obsessivecompulsive personality traits are considered as one of these central mechanisms and transdiagnostic dimensions of ED psychopathology ranging from AN to BN to BED (Fairburn et al. 2003; Cassin & von Ranson, 2005; Meade et al. 2010). Obsessivecompulsive traits have also been linked to obesity (Mount et al. 1990; Petry et al. 2008; Pavan et al. 2013).
相应地，近年来，关于包括肥胖在内的整个 ED 谱系的常见机制的维度概念和跨诊断理论越来越受到关注（Fairburn 等人，2003 年）。事实上，ED 患者经常表现出 ED 类别之间的诊断交叉，并且 ED 和肥胖之间存在相当大的共病，这支持基于可观察行为和神经心理学测量维度的诊断方法（Eddy 等人，2008 年;Castellini 等人，2011 年;Monteleone 等人，2011 年）。强迫性人格特质被认为是 ED 精神病理学的这些中心机制和跨诊断维度之一，范围从 AN 到 BN 再到 BED（Fairburn 等人，2003 年;Cassin & von Ranson， 2005;Meade 等人，2010 年）。强迫性特征也与肥胖有关（Mount 等人，1990 年;Petry 等人，2008 年;Pavan 等人，2013 年）。

Obsessionality and compulsivity have been defined as traits associated with altered neurotransmission in frontostriatal systems (Zastrow et al. 2009), leading to persisting inappropriate actions (Dalley et al. 2011). There is increasing evidence that obsessivecompulsive personality traits play an important role in the development and maintenance of EDs and obesity. For example, compulsive personality traits are considered to represent a heritable factor contributing to ED vulnerability (Lilenfeld et al. 1998, 2000; Anderluh et al. 2003). ED patients are characterized by perfectionism, behavioural rigidity and ritualized behaviours concerning eating, weight and shape (Cassin & von Ranson, 2005; Schmidt & Treasure, 2006; Bardone-Cone et al. 2007). Compulsive behaviour seems to be deeply rooted in the neurobiology of EDs as it is associated with decreased activations in the left and right thalamus, ventral striatum, anterior cingulate cortex and sensorimotor brain regions in women with acute AN, for instance (Zastrow et al. 2009). Correspondingly, it has been suggested that certain cortico-striato-thalamic loops are associated with compulsivity (Robbins et al. 2012).
强迫性和强迫性被定义为与额纹状体系统中神经传递改变相关的特征（Zastrow 等人，2009 年），导致持续的不当行为（Dalley 等人，2011 年）。越来越多的证据表明，强迫性人格特质在 ED 和肥胖的发展和维持中起着重要作用。例如，强迫性人格特质被认为代表了导致 ED 脆弱性的遗传因素（Lilenfeld 等人，1998 年，2000 年;Anderluh 等人，2003 年）。ED患者的特征是完美主义、行为僵化和关于饮食、体重和体型的仪式化行为（Cassin & von Ranson，2005;Schmidt & Treasure， 2006;Bardone-Cone 等人，2007 年）。强迫行为似乎深深植根于 ED 的神经生物学中，因为它与急性 AN 女性左右丘脑、腹侧纹状体、前扣带皮层和感觉运动大脑区域的激活减少有关（Zastrow 等人，2009 年）。相应地，有人认为某些皮质纹状体丘脑环与强迫性有关（Robbins 等人，2012 年）。

At a neuropsychological level, obsessive-compulsive traits may show up as inefficient set-shifting, which is characterized by concrete and rigid approaches to changing rules and stereotypic or perseverative thinking and behaviour (Friederich & Herzog, 2011). By contrast, high levels of set-shifting reflect the ability to easily move back and forth between multiple tasks, operations or mental sets in response to changing goals or environmental experiences (Miyake et al.
在神经心理学层面，强迫症特征可能表现为低效的设定转移，其特点是具体而僵化地改变规则的方法以及刻板或坚持不懈的思维和行为（Friederich & Herzog，2011）。相比之下，高水平的集合转移反映了响应不断变化的目标或环境体验而在多个任务、作或心理设置之间轻松来回移动的能力（Miyake 等人。
2000). Thus, set-shifting may represent a basic executive function that contributes to rigid mental acts and behaviours that are central to the phenomenology of several mental disorders, particularly obsessivecompulsive disorder (OCD) and EDs but also attention deficit hyperactivity disorder (ADHD) and substance dependence (Robbins et al. 2012). Accordingly, poor set-shifting was found in individuals with OCD and those with an ED (Chamberlain et al. 2006; Tchanturia et al. 2012), and also in their unaffected first-degree relatives (Holliday et al. 2005; Chamberlain et al. 2007). The latter finding suggests poor set-shifting to be a stable trait marker that is also seen in the absence of clinically significant symptoms and that may play a central role in the development of EDs and OCD.
因此，移位可能代表一种基本的执行功能，它有助于僵化的心理行为和行为，这是几种精神障碍现象学的核心，特别是强迫症 （OCD） 和 EDs，还有注意力缺陷多动障碍 （ADHD） 和物质依赖（Robbins 等人，2012 年）。因此，在 OCD 患者和 ED 患者中发现移位不佳（Chamberlain 等人，2006 年;Tchanturia 等人，2012 年），以及他们未受影响的一级亲属（Holliday 等人，2005 年;Chamberlain 等人，2007 年）。后一项发现表明，不良的移位是一个稳定的特征标志物，在没有临床显着症状的情况下也可见，并且可能在 ED 和 OCD 的发展中发挥核心作用。

The most common measures of set-shifting in ED research are the Wisconsin Card Sorting Test (WCST; Heaton et al. 1993) and the Trail Making Task (TMT; Halstead, 1947; Reitan & Wolfson, 1985). Less commonly used measures of set-shifting ability in EDs are the Verbal Fluency Test (VFT; Delis et al. 2001), the Intra-Dimensional/Extra-Dimensional (ID/ED) setshifting task (Robbins et al. 1998), the Brixton spatial anticipation test (Burgess & Shallice, 1997), the Object Alternation Test (OAT; Freedman, 1990) and Weigl’s Sorting Test (WST; Weigl, 1941). In addition, the Uznadze haptic illusion task (Uznadze, 1966) has been used in a few studies to assess cognitive flexibility in EDs (Tchanturia et al. 2011, 2012). However, this task also assesses, to a greater extent, abilities of perceptual discrimination (Uznadze, 1966; Tchanturia et al. 2004b).
ED 研究中最常见的集合偏移测量是威斯康星卡片分类测试 （WCST;Heaton 等人，1993 年）和小径制作任务 （TMT;霍尔斯特德，1947 年;Reitan & Wolfson，1985年）。急诊科中不太常用的移位能力测量是语言流利度测试 （VFT;Delis等人。 2001年），维度内/超维度（ID/ED）设置转换任务（Robbins等人。 1998年），布里克斯顿空间预期测试（Burgess & Shallice，1997年），对象交替测试（OAT;Freedman，1990 年）和 Weigl 的排序测试 （WST;Weigl， 1941）。此外，Uznadze 触觉错觉任务 （Uznadze， 1966） 已被用于一些研究来评估 ED 的认知灵活性 （Tchanturia et al. 2011， 2012）。然而，这项任务也在更大程度上评估了知觉辨别能力（Uznadze， 1966;Tchanturia 等人，2004b）。

Numerous studies with primarily small sample sizes have used these tests to investigate set-shifting in ED patients but have yielded fairly inconsistent results. Some studies found evidence for inefficient set-shifting in AN (Fagundo et al. 2012), BN (Roberts et al. 2010) and BED (Svaldi et al. 2010) whereas others failed to do so (Abbate-Daga et al. 2011; Galderisi et al. 2011). There is similar heterogeneity regarding the findings of altered set-shifting in overweight and obesity, with some studies showing reduced set-shifting abilities in affected individuals (Verdejo-Garcia et al. 2010) and some showing no difference between overweight/obese (OW/OB) individuals and normal-weight (NW) controls (Ariza et al. 2012).
许多以小样本量为主的研究使用这些测试来调查 ED 患者的设置偏移，但得出的结果相当不一致。一些研究发现 AN （Fagundo et al. 2012）、BN （Roberts et al. 2010） 和 BED （Svaldi et al. 2010） 中存在效率低下的证据，而其他研究则没有这样做（Abbate-Daga et al. 2011;Galderisi 等人，2011 年）。关于超重和肥胖中改变的移位结果也存在类似的异质性，一些研究表明受影响个体的移位能力降低（Verdejo-Garcia 等人，2010 年），而另一些研究表明超重/肥胖 （OW/OB） 个体与正常体重 （NW） 对照之间没有差异（Ariza 等人，2012 年）。

Several authors have previously summarized empirical findings on cognitive functions (including set-shifting) in EDs and overweight/obesity. However, these reviews either (a) did not use a metaanalytic approach (Van den Eynde et al. 2011; Fitzpatrick et al. 2013) or (b) did not cover the complete spectrum of EDs (AN: Stedal et al. 2012; AN and BN: Roberts et al. 2007; Zakzanis et al. 2010;
几位作者之前总结了关于 ED 和超重/肥胖认知功能（包括集合偏移）的实证发现。然而，这些综述要么 （a） 没有使用元分析方法（Van den Eynde 等人，2011 年;Fitzpatrick 等人，2013 年）或 （b） 没有涵盖 ED 的全部范围（AN：Stedal 等人，2012 年;AN 和 BN：Roberts 等人，2007 年;Zakzanis 等人，2010 年;
overweight/obesity: Fitzpatrick et al. 2013) and did not distinguish between AN subtypes (Roberts et al. 2007; Zakzanis et al. 2010; Stedal et al. 2012); and/or © did only focus on one single measure of set-shifting (Stedal et al. 2012); and/or (d) have not pooled an overall ES, incorporating studies using different measures of set-shifting (Roberts et al. 2007; Van den Eynde et al. 2011). Furthermore, as the number of set-shifting studies in EDs is increasing rapidly, previous reviews on this topic need to be updated.
超重/肥胖：Fitzpatrick 等人，2013 年），并且没有区分 AN 亚型（Roberts 等人，2007 年;Zakzanis 等人，2010 年;Stedal 等人，2012 年）;和/或©只关注一个单一的集合移动测量（Stedal 等人，2012 年）;和/或 （d） 没有合并总体 ES，纳入了使用不同集合偏移测量的研究（Roberts 等人，2007 年;Van den Eynde 等人，2011 年）。此外，由于 ED 中 set shift 研究的数量迅速增加，因此需要更新有关该主题的先前综述。

The aim of the present review was to synthesize the available literature on set-shifting across all three ED subtypes and overweight/obesity by means of meta-analysis. More specifically, the following questions are addressed by this review: (a) Are ED subtypes and overweight/obesity associated with poor setshifting as measured by neuropsychological tests when compared to normal controls? (b) Do ED subtypes differ regarding set-shifting ability? © Do overweight and obese people differ in terms of set-shifting ability? (d) Is there a difference between adult and adolescent individuals with EDs or overweight/obesity regarding set-shifting ability? (e) To what degree are the findings moderated by the specific set-shifting tasks?
本综述的目的是通过荟萃分析综合所有三种 ED 亚型和超重/肥胖的既有文献。更具体地说，本综述解决了以下问题：（a） 与正常对照相比，通过神经心理学测试测量的 ED 亚型和超重/肥胖是否与不良环境转换有关？（b） ED 亚型在设置转换能力方面是否不同？© 超重和肥胖的人在换位能力方面有什么不同吗？（d） 患有 ED 或超重/肥胖的成人和青少年个体在移位能力方面是否存在差异？（e） 研究结果在多大程度上受到特定集合转移任务的调节？

Original articles were searched using four electronic databases: PubMed, PsycINFO, PSYNDEX and Web of Science. Additional searches through reference lists and contacts with expert research groups in this area were conducted. The search strategy focused on cognitive domains related to set-shifting. The following search terms were used: compulsive, compulsivity, mental flexibility, cognitive flexibility, set-shifting, executive function, cognitive control, neurocognitive, neurocognition, neuropsychology, eating disorder, bulimia nervosa, binge eating disorder, anorexia nervosa, binge/purge, binge eating, purging disorder, overweight, obese, and obesity. Literature was searched up until November 2013.
使用四个电子数据库检索原始文章： PubMed 、 PsycINFO 、 PSYNDEX 和 Web of Science 。通过参考文献列表和与该领域的专家研究小组的联系进行了进一步的检索。搜索策略侧重于与集合移动相关的认知领域。使用了以下检索词：强迫、强迫、心理灵活性、认知灵活性、移位、执行功能、认知控制、神经认知、神经认知、神经心理学、进食障碍、神经性贪食症、暴食症、神经性厌食症、暴饮暴食/清除、暴饮暴食、清除障碍、超重、肥胖和肥胖。检索文献截至 2013 年 11 月。

The retrieved titles and abstracts generated from the literature search were screened independently by two of the authors (M.W. and H.-C.F.). For every abstract that was identified as potentially relevant by at least one of these two authors, the full-text article was retrieved for evaluation, which was completed independently by M.W. and H.-C.F. Discrepancies were resolved by discussion.
从文献检索中检索到的标题和摘要由其中两位作者 （M.W. 和 H.-C.F.） 独立筛选。对于这两位作者中至少一位确定为可能相关的每篇摘要，都会检索全文文章进行评估，评估由 M.W. 和 H.-C.F. 独立完成。通过讨论解决了分歧。

The classification of tasks as set-shifting measures was based on the information provided in the publications and discussions among all authors. As mentioned
将任务分类为移位措施是基于出版物中提供的信息和所有作者之间的讨论。如前所述
in the Introduction, the two most commonly used tests were the WCST and the TMT. In the WCST, participants are required to match stimulus cards with one of four category cards. The sorting rule can be according to colour, shape or number of the displayed symbols. The rules switch unpredictably during task administration and have to be inferred repeatedly by the participant. Perseveration errors seem to be the most widely used and most sensitive performance index of the WCST. This index is obtained by counting the number of times a participant sorts the cards according to a previously correct but currently false principle, despite negative feedback from the test (Pennington & Ozonoff, 1996). In the TMT, the participants are first asked to numerically connect numbered circles (i.e. 1-2-3; trail A) and then to alternatively link numbers and letters (i.e. 1-A-2-B-3-C; trail B). Set-shifting performance is indexed by the time taken to complete trail B correctly or by the difference between the time taken for trail A and trail B (Crowe, 1998).
在引言中，最常用的两种测试是 WCST 和 TMT。在 WCST 中，参与者需要将刺激卡与四个类别卡中的一张相匹配。排序规则可以根据显示符号的颜色、形状或数量。在任务管理期间，规则会不可预测地切换，并且必须由参与者反复推断。Perseveration 误差似乎是 WCST 使用最广泛、最敏感的性能指标。这个指数是通过计算参与者根据以前正确但目前错误的原则对卡片进行排序的次数而得到的，尽管测试中有负面反馈（Pennington & Ozonoff），1996年）。在 TMT 中，参与者首先被要求以数字方式连接带编号的圆圈（即 1-2-3;轨迹 A），然后交替连接数字和字母（即 1-A-2-B-3-C;轨迹 B）。布景转换性能由正确完成轨迹 B 所花费的时间或轨迹 A 和轨迹 B 所花费的时间之间的差异来索引（Crowe，1998）。

A priori criteria for the inclusion of original studies into the present meta-analysis were that they (a) were peer-reviewed original research articles; (b) compared at least one clinical group of ED patients (minimum age 10 years) with a healthy control group or compared at least one group of OW/OB individuals (minimum age 10 years) with a NW control group; © differentiated clearly between ED subtypes (participants had to meet either DSM-III, DSM-IV or ICD-10 criteria for current AN, BN or BED; for ED studies only); (d) provided detailed descriptions of sociodemographic variables; (e) used at least one neuropsychological task that assessed set-shifting; and ( $f$$f$ff ) provided sufficient statistical information to allow the calculation of effect sizes (ESs).
将原始研究纳入本荟萃分析的先验标准是它们 （a） 是同行评审的原始研究文章;（b） 将至少一组临床 ED 患者 （最低年龄 10 岁） 与健康对照组进行比较，或将至少一组 OW/OB 个体 （最低年龄 10 岁） 与 NW 对照组进行比较;© 明确区分 ED 亚型（受试者必须满足当前 AN、BN 或 BED 的 DSM-III、DSM-IV 或 ICD-10 标准;仅适用于 ED 研究）;（d） 提供了社会人口学变量的详细描述;（e） 使用了至少一项评估布景转移的神经心理学任务;（ $f$$f$ff ） 提供了足够的统计信息以允许计算效应量 （ES）。

For data extraction (study characteristics, study results and quality assessment), we used a standardized form developed prior to the literature search. All discrepancies were rechecked and disagreements were resolved by discussion with all authors. Descriptive statistics (means, standard deviations and sample sizes) for the main outcome measures of relevant tasks in ED patients and healthy controls and also in OW/OB individuals and NW participants were extracted for the calculation of ESs. For articles that did not report means and/or standard deviations, $p$$p$pp values and sample sizes were used. Additionally, the following information was extracted from each study to aid the quality description and assessment of the study: diagnostic criteria, inclusion criteria, exclusion criteria, source of sample, sample size, sample demographics
对于资料提取（研究特征、研究结果和质量评估），我们使用了在文献检索之前开发的标准化表格。重新检查所有差异，并通过与所有作者讨论解决分歧。提取 ED 患者和健康对照者以及 OW/OB 个体和 NW 参与者相关任务的主要结果测量的描述性统计 （平均值、标准差和样本量） 用于计算 ES。对于未报告均值和/或标准差的文章， $p$$p$pp 使用值和样本量。此外，从每项研究中提取了以下信息，以帮助对研究进行质量描述和评估：诊断标准、纳入标准、排除标准、样本来源、样本量、样本人口统计学