Cognitive Remediation Therapy

Patients with anorexia nervosa often exhibit compulsive behaviors related to nutrition, body shape, and weight. Additionally, cognitive rigidity and strongly pronounced behavioral routines can be observed in their daily lives, even beyond these topics. These are often embedded in obsessive personality traits, which are considered a risk factor for anorexia nervosa and have been associated with a poorer prognosis. At the neuropsychological level, this is reflected in reduced set-shifting and decreased central coherence. Cognitive remediation therapy targets these fundamental cognitive functions, aiming to promote cognitive flexibility and “bigger picture” thinking as an additional treatment component. The intervention includes cognitive exercises, behavioral experiments, and metacognitive elements. The effectiveness of this approach in improving cognitive functions and clinical parameters has recently been questioned by several clinical studies. Currently, the intervention can only be recommended to a limited extent as an additional component in the treatment of anorexia nervosa.