Difficulties in retrieving specific details of autobiographical memories and imagining positive future events in individuals with acute but not remitted anorexia nervosa

Plain English summary Problems with generating future episodic thoughts are a feature of depression, and depression is commonly present in individuals with anorexia nervosa (AN). In this study, the ability to remember autobiographical events and to think about events in the future was measured using a standardised task, in a group of 46 individuals with AN, 40 individuals recovered from AN and 35 individuals without AN. The results showed that individuals with AN showed difficulties in recalling specific details of autobiographical memories, and rated them as less positive and vivid. People with current AN or recovered from AN reported greater difficulty in recalling autobiographical memories. Lastly, people with AN produced less positive episodic future events. Comorbid depressive symptoms had some contribution to these difficulties. This study suggests that individuals with AN have difficulty recalling specific details of autobiographical memory and generating positive episodic future thoughts. This is likely to cast a negative bias on their view of the future, which could lessen hope for recovery. Introduction The factors that contribute to the maintenance of anorexia nervosa (AN) are not fully understood, although it is generally accepted that depression is a core feature and contributes to poor prognosis. Individuals with depression tend to have difficulties in producing specific details of autobiographical memories and future episodes. Our aim was to investigate autobiographical memory and episodic future thinking (EFT) in individuals with AN (n = 46), people recovered from AN (recAN; n = 40), and non-affected controls (n = 35). Method Using a remotely administered computerised version of the autobiographical memory test and episodic future thinking task, we measured six aspects of memory retrieval and EFT generation: specificity, detailedness, difficulty in remembering/imagining, positivity, vividness and realism. Memory and EFT cue valence was manipulated; cues were either positive, neutral, or disorder-related/negative. As the production of EFTs is theoretically linked to the ability to retrieve autobiographical memories, the relationship between autobiographical memory specificity and EFT specificity was explored. To investigate whether autobiographical memory and EFT performance were independent of performance on other forms of cognition, working memory, verbal fluency and cognitive flexibility were measured. Results People with AN had difficulties retrieving specific details of autobiographical memories and rated autobiographical memories as less positive overall, and less vivid when primed by positive cues. People with a lifetime diagnosis (currently ill or recovered) reported greater difficulty in retrieving memories. The AN group generated less positive EFTs, particularly to positive and neutral cues. Comorbid depressive symptoms had some contribution to the observed findings. Lastly, in all groups autobiographical memory specificity predicted EFT specificity. Discussion Problems with retrieving specific details of autobiographical memories and simulating positive EFTs may be a state feature of AN. Treatments targeted at alleviating depressive symptoms, as well those targeted towards facilitating memory retrieval or reconsolidation, and the construction of positive EFTs, may contribute to hope for recovery and strengthen the sense of self beyond the disorder.

Automated summary

This study suggests that individuals with anorexia nervosa have difficulties in recalling specific details of autobiographical memory and generating positive episodic future thoughts. These difficulties may contribute to a negative bias on their view of the future and lessen hope for recovery.