Translating laboratory research into practice: foundations, functions and future of cognitive remediation therapy for anorexia nervosa

Emma Baldock and Kate Tchanturia

Cognitive remediation therapy for anorexia nervosa is a model of the translation of neuroscientific research into clinical practice. It is designed to improve the symptoms and general functioning of patients by remediating their cognitive deficits. In this report, we review its empirical foundations (basic and clinical) and its functions (what it targets and how) and provide a speculative view of its future over the next decade. Neuropsychological research has established that anorexia nervosa is associated with the traits of cognitive inflexibility and an excessively detailed information processing style, with neglect of the gestalt. These deficits are manifest, not only in the core pathology of the disease, but also in other areas of patients’ lives. There is evidence that these traits can be remediated, and further study will establish whether this remediation brings secondary benefits in symptomatology and general functioning. We predict that within the coming years, a better understanding of the relative roles of strategy learning and brain exercise in cognitive remediation therapy will improve the design of interventions; that CRT will be increasingly well tailored to meet the specific neuropsychological and clinical profile of patients; and that it will be effective in different forms for both severe and mild cases of anorexia nervosa, in both in- and out-patient settings. We also propose that it will be key to exploiting the benefits of standard psychological therapies.