The Journal of General Psychology

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Speed of Processing Time Slowing in Eating

Disorders

F. Richard Ferraro, Rachel Kramer & Stephanie Weigel

To cite this article: F. Richard Ferraro, Rachel Kramer & Stephanie Weigel (2018) Speed of
Processing Time Slowing in Eating Disorders, The Journal of General Psychology, 145:1, 79-92,
DOI: 10.1080/00221309.2017.1421136

To link to this article: https://doi.org/10.1080/00221309.2017.1421136

Published online: 31 Jan 2018.

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THE JOURNAL OF GENERAL PSYCHOLOGY
, VOL. , NO. , –
https://doi.org/./..

Speed of Processing Time Slowing in Eating Disorders

F. Richard Ferraro, Rachel Kramer, and Stephanie Weigel
University of North Dakota, Grand Forks, ND, United States

ABSTRACT ARTICLE HISTORY

We applied Brinley (1965) plot analysis to the eating disorders Received  February 
field. Across 23 studies and 165 experimental conditions [experi- Accepted  December 
enced by a total of 773 eating disorder (ED) participants, including
KEYWORDS
anorexia nervosa (AN), binge eating (BE), bulimia nervosa (BN), Eating disorder; reaction
and eating disorders not otherwise specified (EDNOS) and 995 time; slowing
controls], the best-fit regression equation was Y (ED) = 1.08
X (CONTROL) – 31. This equation accounted for 98.2% of the
variance. Thus, the ED subjects were only 1.08 times slower than
the control subjects, suggesting little processing speed slowing
in ED. We also examined simple reaction time [SRT; Y (ED) =
.91 X (CONTROL) + 63; variance accounted for = 93.6%] and
choice reaction time (CRT; Y (ED) = 1.12X (CONTROL) – 43, variance
accounted for = 99.7%). These slopes are significantly different.
ED subjects are more impacted when the task involves a decision
component (CRT) than when it does not (SRT).

The study and use of reaction time (RT) to investigate speed of mental processes
has a long history, starting with work of Donder’s in the 19th century. His subtrac-
tive method assumed that cognitive operations could be added and subtracted with
little effect on other cognitive operations. So if Task A required 1 process (encoding
of a specific stimulus) and Task B required 2 processes (Process 1: encoding; Process
2: decision), Donder reasoned that the duration of the decision would be as simple as
(RT for B – RT for A). This view has been updated with Sternberg’s (1969) additive
factors logic view, which asserted that speed of processing can and often does change
when combined with other processes. If two tasks do not impact other processes,
there would be main effects only. If, however, these processes do impact each other,
one would expect an interaction to occur in which the effect of one independent
variable (IV) depends on the level of another IV. Thus, a discrete model of infor-
mation processing was advanced and related to Encoding-Comparison-Decision-
Respond stages. Discrete models eventually gave way to interactive types of models
in which, for instance, stage two of a four-stage model could begin before stage 1
had been completed.

CONTACT F. Richard Ferraro f.richard.ferraro@email.und.edu Psychology, University of North Dakota, Stop

, Grand Forks, ND,  United States.
©  Taylor & Francis Group, LLC
80 F. R. FERRARO ET AL.

Such overlapping models are often used to explain individual differences.

For example, these models have examined good versus poor readers, or fast or
slow subjects on other cognitive tasks. Reaction time is now ubiquitous in many
information-processing tasks, including memory, attention, problem solving, and
decision making. So too are error rate and percent correct analyses. Depending on
the RT task, error rates may be relatively small (task is too easy) or relatively large
(task is too hard), although many researchers like to see 90% correct responses if
possible. Most RT experiments instruct subjects to be as fast and as accurate as
possible, and while one can be fast and error-free and slow and error-prone, it is
important to show adequate speed-accuracy trade-off (SATO). SATO’s can have
detrimental effects in that subjects may be fast but make lots of errors,or slow and
make few errors. Reaction time and its analysis remains one of the most frequently
studied independent variables in several areas of psychology. How RT relates to
information processing slowing also shares a long history in psychology and related
areas, and several methodologies have been employed to investigate such slowing.
One such methodology was initially proposed by Brinley (1965), who was interested
in the RT and information processing slowing that resulted from adult aging.
In 1965, Brinley examined task switching in younger and older adults. His
analysis demonstrated that older adults were 1.7 times slower than younger adults
using multiple regression analyses in which the slope value (1.7 here) is the result
of regressing the older adult RTs onto the younger adult RTs across consistent
experimental conditions in which each group participated. Brinley’s initial article
on processing speed and general slowing in older adults was influential in the
emerging field of cognitive aging. Since that time, many in the psychology field
have championed the use of Brinley plot analysis for subjects including cognitive
aging, developmental psychology, closed head injury, clinical, and psychophar-
macology (e.g., Ferraro, 1996; Hardy & Hinkle, 2002; Meiran, Levine, Meiran, &
Henik, 2000; Pocklington & Maybery, 2006; Verhaeghen & Cerella, 2002). In 2003,
Myerson, Adams, Hale, and Jenkins provided a review of this literature as a way
to examine relative processing speed issues both within and across individuals and
various groups in both basic research as well as the application of these results for
clinical practice. In a typical Brinley Plot analysis, a set of criteria are established,
and peer-reviewed research articles are gathered in which the experimental and
control groups participate in the same experimental conditions. Then the RTs of
the experimental groups are regressed onto the RTs of the control groups and the
best-fit regression line is fit to the resulting data points.
Ferraro (1996) used the same Brinley plot analysis to examine slowing evidenced
by individuals with a closed head injury (CHI). Across 13 simple and choice RT
studies of 353 CHI subjects and 329 non CHI subjects and 101 experimental
conditions, the best-fit equation that resulted from regressing the CHI data onto
the Control data for matched conditions was Y(CHI) = 1.54 X(CONTROL) –
59, and this specific regression equation accounted for approximately 89% of the
variance (based on R-Squared). Results suggested that the basic processes involved
in simple- and choice-RT performance were approximately 1.54 times slower in
 THE JOURNAL OF GENERAL PSYCHOLOGY 81

CHI individuals in this sample as compared to non-CHI (control) individuals.

This pattern of performance substantiates the observation that the CHI results
in a slowing of even very basic cognition information processes. In 2016, Ferraro
expanded the application of Brinley plot analysis, evaluating RT in the Autism
Spectrum Disorder (ASD) literature and found the best-fitting regression equation
of Y (ASD) = .99 X (CONTROL) + 88.3, R-squared = 92.4 %, showing little if any
processing speed slowing associated with individuals with ASD, at least as confined
to the 32 studies used in this Brinley plot analysis. Brinley plot analysis has been
used across other populations as well, including human immunodeficiency virus
(HIV; Hardy & Hinkin, 2002), Alzheimer’s disease (Madden, Nebes, & Allen, 1992),
developmentally disabled adults (Kail, 1992), and older adults (Bashore, 1990).
The field of eating disorders (ED) has long used RT as an important independent
variable in much research examining how ED individuals process information. For
instance, in 2014, Smith, Joiner, and Dodd showed how ED individual’s process
information remains a critical component of empirical research into eating disor-
ders. They used a lexical decision task (LDT), which is one of the premier tasks
used in the reaction time literature (Balota, Cortese, Sergent-Marshall, Spieler, &
Yap, 2004), and found that subjects with Anorexia Nervosa (AN) responded faster
to both beautiful and ugly words, as compared to control (non-AN) subjects. This
pattern suggests that the AN subjects automatically and implicitly had stronger
associations between emaciation and both beauty and ugliness. However, not all ED
studies show this type of pattern in which ED subjects respond faster. For instance,
Dalmaso et al. (2016)) showed altered social attention in individuals with AN on a
form of the RT-based inhibition of return (IOR) paradigm. In the IOR task, longer
RTs usually result when an individual responds to a location previously searched
for in comparison to locations not searched for. In this version of the IOR, subjects
had to perform rapid aiming movements individually or with another person in
attendance. AN subjects displayed non-significant individual IOR performance but
significant social IOR performance. Thus, there were RT differences in AN individ-
uals which reflected reduced sensitivity in body-related stimuli processing only with
peers. Likewise, Myers, Ridolfi, and Crowther (2015)) showed that women with
eating pathology displayed longer RTs when processing appearance-related word
stimuli that control subjects. Thus, the eating disorders literature contains some
studies showing RT benefits and some showing RT costs with no clear pattern of RT
processing and RT slowing, even when investigating specific types of EDs. This is
not a new issue for the ED literature, however. In 2017, Jiang and Vartanian showed
that when measuring attention bias in ED, type of task is critical. Attentional bias is
an RT-based procedure that has various tasks associated with it. These tasks include
dot probe, visual search, and eye-tracking. They found that some tasks are more
appropriate based on what type(s) of questions researchers are asking. Dot probe
and visual search allow for analysis of attentional mechanisms, while eye-tracking
is a more observable attentional measure.
What is critical here is that individual studies investigating similar areas of
research often show the same or different results. One positive aspect of Brinley plot
82 F. R. FERRARO ET AL.

analyses, like other meta-analytic techniques, is that similarities and differences

across individual studies can be examined from a combined perspective. That
is, when combining results from various (and often contradictory) studies, the
result allows for increased power (over individual studies), improvement regarding
estimates of individual study effects sizes, and ability to resolve uncertainty when
reports disagree.
The current study is an attempt to better understand the eating disorder slowing
literature. Use of Brinley plot analysis has also advanced what is termed the Gen-
eral Slowing theory (see Myerson, Adams, Hale, & Jenkins, 2003). That is, the slope
measurement detailed previously is used as a metric for quantifying how slow (or
not how slow) individuals from a particular subject group are in comparison to a
control group of subjects matched on various factors. So, if the regression equation
slope between Groups A and B is 1.5, one can say that Group A is 1.5 times slower
than Group B. Likewise, a slope of 1.0 would suggest little if any slowing between the
groups. Thus, the General Slowing theory allows much latitude in discussions and
predictions about how various conditions or factors (e.g., age, closed head injury,
autism spectrum disorder) impact speed of processing.

The present study

In the present paper, we applied the Brinley plot analysis to the eating disorders field
in an attempt to determine issues related to processing speed and general slowing.
To date, no such Brinley plot analysis has been performed within the eating dis-
orders literature, although there appears to be considerable debate regarding how
RT is impacted by various types of eating disorders, with some studies showing RT
slowing and others not showing RT slowing. The relevance of our study is that it is
the first to apply this methodology in a systematic way to the eating disorder liter-
ature. Thus, these results may offer a starting point for a further refinement of how
RT is impacted by eating disorders of various types and further decipher any con-
tradictory findings related to RT and RT task. As with Ferraro (1996, 2016), we used
established criteria for which articles to include in our analysis. Given the current
literature in ED and RT, which shows some studies confirming an RT slowdown
and others not confirming this RT slowdown, one would expect the regression
slope value (which is a measure of slowing based on the Brinley plot analysis) to be
between 1.0 and 1.5. Alternatively, issues related to task type (simple reaction time,
choice reaction time) as well as subject type (based on ED criteria) may show a
different pattern of results. For instance, simple reaction time (SRT) tasks are often
easier than choice reaction time (CRT) tasks. Thus there may be less ED slowing on
these tasks (SRT) as compared to more complex tasks involving decision making
(e.g., CRT). Likewise, examination of different categories of ED may show differing
slowing ratios, with more severe ED subjects showing greater slowing, as compared
to non-ED controls.
From a theoretical perspective, it is important to know where in the information-
processing sequence eating disorders impacts the underlying mechanisms
 THE JOURNAL OF GENERAL PSYCHOLOGY 83

associated with cognitive processing. That is, do eating disorders result in so-
called General Slowing impacting all aspects of information processing, or is the
slowing localized to a specific part of the information-processing sequence? Our
task (simple RT, choice RT) analysis using Brinley plots will allow us to provide an
answer to this question. Slowing observed in both SRT and CRT would suggest a
generalized slowing associated with critical aspects of information processing—
namely, does adding a decision component (CRT) also slow the processing system.
Likewise, showing slowing in CRT but not SRT would suggest adequate information
processing until a decision is required. The addition of this decision component
would increase RT (and slope) and error rate and, as a result, slow down the
subject’s response times. Finally, showing no SRT or CRT slowing would suggest
that information processing deficits are spared in ED as they relate to RT. As such,
processes other than RT would be a more likely candidate for cognitive deficits
in ED.

Methods

Procedure
Google Scholar and PsychINFO were employed as the search engine and was
searched for the time frame 1992–2017 using the following search terms: Eating
Disorders, RT, reaction time. The following criteria were used to select studies:
(1) Studies chosen used mean RT as the dependent variable; (2) RTs could not be
faster than 145 milliseconds (ms) or slower than 4200 ms;, (3) a comparable control
group (non-ED) was included that participated in the same set of experimental con-
ditions; (4) at least one experimental condition common to both subject groups, (5)
RT values appeared in table form in the manuscript, and (6) all subjects were adults
(i.e., no children were included).
Table 1 lists each of the 23 studies, the type of task, number of experimental condi-
tions in which the ED and control groups each participated, sample characteristics,
and how the diagnosis of ED was made based on the search criteria listed above.

Results & discussion

Application of these criteria resulted in a total of 23 empirical articles covering
the time frame 1992–2017 (see Table 1). Across these 23 studies, we identified a
total of 157 experimental conditions experienced by a total of 773 eating disor-
der (ED) participants, including anorexia nervosa (AN), binge eating (BE), bulimia
nervosa (BN), eating disorders not otherwise specified (EDNOS), and 995 control
participants.
When we regressed, the ED RT data onto the control data across these 157 con-
ditions, the best-fit regression equation was Y (ED) = 1.08 X (Control) – 31 and it
accounted for 98.2% of the variance. This is presented in Figure 1. Thus, in this sam-
ple of studies, the ED subjects were only 1.08 times slower than the control subjects,
84 F. R. FERRARO ET AL.

Table . Characteristics of the  studies used in the present Brinley plot analysis.
Study # 
Blechert, J., Ansorge, U., & Tuschen-Caffier, B. (). A body-related dot-probe task reveals distinct attentional
patterns for bulimia nervosa and anorexia nervosa. Journal of Abnormal Psychology, , –.
Task(s): CRT
Conditions/Data Points: :  (BN),  (AN)
ED: N =  w/ Anorexia Nervosa (AN);  with Bulimia Nervosa (BN), all female, diagnosed with DSM-IV
Control: N = , all female
Study # 
Boisseau, C. L., Thompson-Brenner, H., Caldwell-Harris, C., Pratt, E., Farchione, T., & Barlow, D. (). Behavioral and
cognitive impulsivity in obsessive-compulsive disorder and eating disorders. Psychiatry Research, , –.
Task: CRT
Conditions/Data Points: :  (BN),  (EDNOS)
ED: N =  ( w/ BN,  w/ Eating Disorder Not Otherwise Specified; EDNOS), diagnosed with DSM-V
Control: N = 
Study # 
Bosanac, P., Kurlender, S., Stojanvska, L., Hallam, K., Norman, T., McGrath, C …. Olver, J. (). Neuropsychological
study of underweight and “weight-recovered” anorexia nervosa compared with bulimia nervosa and normal
controls. International Journal of Eating Disorders, , –.
Task: CRT
Conditions/Data Points: :  (BN),  (AN)
ED: N =  w/ BN,  w/ AN, diagnosed using DSM-IV
Control: N = 
Study # 
Butler, G. K. L., & Montgomery, A. M. J. (). Subjective self-control and behavioral impulsivity coexist in anorexia
nervosa. Eating Behaviors, , –.
Task: SRT
Conditions/Data Points:  (AN)
ED: N = , all female with AN
Control: N = , all female
Study # 
Claes, L., Nederkoorn, C., Vandereycken, W., Guerrieri, R., & Vertommen, H. (). Impulsiveness and lack of
inhibitory control in eating disorders. Eating Behaviors, , –.
Task: CRT
Conditions/Data Points: :  (BN),  (AN)
ED: N =  AN,  BN (diagnosed with DSM-IV)
Control: N = 
Study # 
Cooper, M. J., Anastasiades, P., & Fairburn, C. G. (). Selective processing of eating shape-, and weight-related
words in persons with bulimia nervosa. Journal of Abnormal Psychology, , –.
Task: SRT
Conditions/Data Points:  (BN)
ED: N =  BN, DSM-III
Control: N = 
Study # 
Fassino, S., Piero, A., Daga, G. A., Leombruni, P., Mortara, P., & Rovera, G. G. (). Attentional biases and frontal
functioning in anorexia Nervosa. International Journal of Eating Disorders, , –.
Task: SRT
Conditions/Data Points:  (AN)
ED: N =  AN
Control: N = 
Study # 
Galimberti, E., Martoni, R. M., Cavallini, M. C., Erzegovesi, S., Bellodi, L. (). Motor
inhibition and cognitive flexibility in eating disorder subtypes. Progress in Neuro-Psychopharmacology and
Biological Psychiatry, , –.
Task: SRT
Conditions/Data Points: :  (BN),  (AN)
ED: N =  ( AN,  BN), all female, DSM-IV diagnosis
Control: N = 
(Continued on next page)
 THE JOURNAL OF GENERAL PSYCHOLOGY 85

Table . Continued

Study # 
Green, M. M., McKenna, F. P., & DeSilva, M. S. (). Habituation patterns to colour naming in eating-related stimuli
in anorexics and non-clinical controls. British Journal of Clinical Psychology, , –.
Task: SRT
Conditions/Data Points:  (AN)
ED: N =  AN
Control: N = 
Study # 
Green, M. W., Wakeling, A., Elliman, N. A., & Rodgers, P. J. (). Impaired colour naming of clinically salient words
as a measure of recovery in anorexia nervosa. Behavioral and Cognitive Psychotherapy, , –.
Task: SRT
Conditions/Data Points:  (AN)
ED: N =  AN
Controls: N = 
Study # 
Johansson, L., Carlbring, P., Ghaderi, A., Andersson, G. (). Emotional Stroop via internet among individuals with
eating disorders. .Scandinavian Journal of Psychology, , –.
Task: SRT
Conditions/Data Points: :  (BN),  (AN)
ED: N =  (BN), N =  AN
Control: N = 
Study # 
Jones-Chesters, M. H., Monsell, S., & Cooper, P. J. (). The disorder-salient Stroop effect as a measure of
psychopathology in eating disorders. International Journal of Eating Disorders, , –.
Task: SRT
Conditions/Data Points:  (BN)
ED: N =  BN
Control: 
Study #
Mendlewicz, L., Nef, F., & Simon, Y. (). Selective handling of information in patients suffering from restrictive
anorexia in an emotional Stroop test and a word recognition test. Neuropsychobiology, , –.
Task: CRT
Conditions/Data Points:  (AN)
ED: N =  AN
Control: N = 
Study # 
Nikendei, C., Weisbrod, M., Schild, S., Bender, S., Walther, S., Herzog, W., Zipfel, S., & Friedrish, H. C. (). Anorexia
nervosa: Selective processing of food-related word and pictorial stimuli in recognition and free recall tests.
International Journal of Eating Disorders, , –.
Task: CRT
Conditions/Data Points:  (AN)
ED: N =  AN
Control: N = 
Study # 
Pieters, G. L. M., de Bruijn, E. R. A., Maas, Y., Hulstijn, W., Vandereycken, W., Peuskens, J., & Sabbe, B. G. (). Action
monitoring and perfectionism in anorexia nervosa. Brain & Cognition, , –.
Task: CRT
Conditions/Data Points:  (AN)
ED: N =  AN
Control: N = 
Study # 
Pieters, G., Hulstijn, W., Vandereycken, W., Maas, Y., Probst, M., Peuskens, J., & Sabbe, B. (). Fast psychomotor
functioning in anorexia nervosa: Effect of weight restoration. Journal of Clinical and Experimental Neuropsychology,
, –.
Task: SRT
Conditions/Data Points:  (AN)
ED: N =  AN, DSM-IV
Control: N = 
(Continued on next page)
86 F. R. FERRARO ET AL.

Table . Continued

Study # 
Pieters, G., Sabbe, B., Hulstijn, W., Probst, Vandereycken, W., & Peuskens, J. (). Fast psychomotor functioning in
underweight anorexia nervosa patients. Journal of Psychiatric Research, , –.
Task: SRT
Conditions/Data Points:  (AN)
ED: N =  AN, DSM-IV
Control: N = 
Study # 
Schober, I., Renwick, B., de Johg, H., Kenyon, M., Sharpe,H., Jacobi, C., & Schmidt, U. (). Threat-related
attentional bias in anorexia nervosa. International Journal of Eating Disorders, , –.
Task: CRT
Conditions/Data Points:  (AN)
ED: N = : (AN, EDNOS-AN), DSM-IV
Control: N = 
Study # 
Smeets, E., Roefs, A., Van, F. E., & Jansen, A. (). Attentional bias for body and food in eating disorders: Increased
distraction, speeded detection or both? Behavioral Research & Therapy, , –.
Task: CRT
Conditions/Data Points:  (EDNOS)
ED: N =  EDNOS
Control: N = 
Study # 
Smith, A. R., Joiner, T. E., & Dodd, D.R. (). Examining implicit attitudes toward emaciation and thinness in
anorexia nervosa. International Journal of Eating Disorders, , –.
Task: CRT
Conditions/Data Points:  (AN)
ED: N =  AN, all female
Control: N = , all female
Study #
Stormark, K. M., & Torkildsen, O. (). Selective processing of linguistic and pictorial food stimuli in females with
anorexia nervosa. Eating Behaviors, , –.
Task: CRT
Conditions/Data points:  (EDNOS)
ED: N =  EDNOS
Control: N = 
Study # 
Wu, M., Giel, K. E., Skunde, M., Schag, K., Rudofsky, G., Zwaan, M., Zipfel, S., Herzog, W., & Friederich, H-C. ().
Inhibitory control and decision-making under risk in bulimia nervosa and binge-eating disorder. International
Journal of Eating Disorders, , –.
Task: SRT
Conditions/Data Points: :  (BN),  (BED)
ED: N =  BN,  Binge Eating Disorder
Controls: N = , 
Study #
Bartholdy, S., Rennalls, S. J., Jacques, C., Danby, H., Campbell, I. C., Schmidt, U., & O’Daly, O. G. (). Proactive and
reactive inhibitory control in eating disorders. Psychiatry Research, , –.
Task: SRT
Conditions/Data Points: :  (AN),  (BN),  (BED, )
ED: N =  AN,  BN,  BED
Controls: N = 

Note. BN indicates bulimia nervosa; AN indicates anorexia nervosa; EDNOS indicates eating disorder not otherwise spec-
ified; BED indicates binge eating disorder; Conditions/Data Points indicates that the number of conditions are also
the number of X,Y data points plotted; BN contributed  conditions/data points,  experimental subjects,  con-
trol subjects; AN contributed  conditions/data points,  experimental subjects,  control subjects; EDNOS con-
tributed  conditions/data points,  experimental subjects,  control subjects; BED contributed  conditions/data
points,  experimental subjects,  control subjects.
 THE JOURNAL OF GENERAL PSYCHOLOGY 87

Figure . Brinley plot of Eating Disorder (ED) RT data regressed on to Control (non-ED) data across all
 studies listed in Table .

suggesting there is little of any processing speed slowing in this specific sample of ED
studies. An additional Brinley plot analysis, examining simple reaction time [SRT;
Y (ED) = .91 X (Control) + 63, variance accounted for = 93.6%] and choice reaction
time (CRT; Y (ED) = 1.12 (Control) – 43; variance accounted for = 99.7%), showed
greater RT slowing (SRT slope is .91, CRT slope is 1.12) based on task type in the ED
group. These slopes are also significantly different than each other, t (121) = 7.15,
p < .01. (In this analysis, the original 23 studies (see Table 1) were broken down into
studies using SRT or CRT tasks. This analysis yielded 12 SRT studies and 11 CRT
studies. The SRT Brinley plot is in Figure 2 and the CRT Brinley plot is in Figure 3.
In the present study, we employed Brinley plot analyses to the field of eating dis-
orders, which is a first such application to our knowledge. Our main findings sug-
gest that RT slows by only 1.08 times in ED subjects (including those diagnosed
with anorexia nervosa, binge eating, bulimia nervosa, and eating disorders not oth-
erwise specified) as compared to non-ED Controls. However, when we broke this
analysis down based on whether the main task was SRT or CRT, the slope for the
CRT tasks was 1.12 while the slope for the SRT tasks was .89. These various results
highlight the notion that CRT tasks may be more demanding and more difficult for
ED subjects, as evidence by the increase in the slope value from .89 (SRT) to 1.12
(CRT). These results bolster the finding that some ED studies show RT differences
and some do not (Dalmaso et al., 2016; Smith, Joiner, & Dodd, 2014). Our results
suggest that task difficulty (CRT is more difficult than SRT based on the fact that
CRT tasks include a decision component, whereas SRT tasks do not. Additionally,
one possible answer to this question is that there is much variability across tasks and
88 F. R. FERRARO ET AL.

Figure . Brinley plot of Eating Disorder (ED) Reaction Time (RT) data regressed on Control (Non-ED)
data across  Simple Reaction Time (SRT) Studies listed in Table .

Figure . Brinley plot of Eating Disorder (ED) Reaction Time (RT) data regressed on Control (Non-ED)
data across  Choice Reaction Time (CRT) Studies listed in Table .
 THE JOURNAL OF GENERAL PSYCHOLOGY 89

subjects in the present set of studies such that those individual studies that showed
differences were cancelled out by those studies that showed no differences.
There is also evidence that the increases in the variability associated with reaction
time (SRT as well as CRT) often results in less efficient processing (MacDonald, Li,
& Backman, 2006) and is also tied to less efficient structural as well as functional
aspects of brain networks. We did examine variability in the present set of studies,
as they included measures of RT variability (standard deviations, or SD). The lack
of any ED/Control group differences across ED groups as well as task type suggests
that individuals with ED may possess similar levels of RT variability. As a result,
they tend to process information in much the same way as individuals without ED,
at least within the confines of the studies sampled in our present findings. Across the
23 studies examined presently, the correlation coefficient between RT and RTSD was
r = +.768, p < .01, confirming our suggestion above. Likewise, when we regressed
ED SD data on to the CONTROL SD data, the resulting best-fit regression equation
was Y (ED) = .98 X (CONTROL) + 22, RSQ = 78.5%, suggesting no differences
between the two groups.
Despite these various findings, there are some shortcomings that need to be dis-
cussed. First, the 23 studies we used cover a wide array of ED’s. However, when the
larger sample was broken down into different types of eating disorders, the best-fit
equations were very similar. For Anorexia Nervosa: Y (AN) = .97 X + 26, RSQ =
93.8%; for Binge Eating: Y (BE) = 1.03 X – 9, RSQ = 97.1%; for Bulimia Nervosa:
Y (BN) = 1.01 X – 21, RSQ = 94.8%; for Eating Disorder Not Otherwise Specified:
Y (EDNOS) = 1.11 X – 2, RSQ = 99.7%). These four equations are very similar
to the original equation, which contained all four ED sub-types. Second, some of
the studies we included offer up more common experimental methodologies (i.e.,
Stroop) than other studies (Go-No Go Task). Thus, some tasks may be more cog-
nitively demanding than other tasks, and our SRT/CRT analyses again showed a
greater slope for the CRT tasks as compared to the SRT tasks; t (121) = 7.16, p <
.01. By isolating task type (SRT, CRT) and group type, these analyses offer a more
fine-grained investigation into RT slowing that has been found in some studies.
Examination of SRT and CRT allow for an examination of whether the addition
of a decision component (CRT) increases overall RT, as one might expect. Showing
a greater slope and RT increase when comparing SRT and CRT suggests that the
underlying processes of making a decision are impacting the overall RT in ED sub-
jects, further suggesting that having to make a decision (the hallmark of CRT tasks)
is potentially impacting information processing in ED. Likewise, examination of dif-
ferent subtypes of ED allows for predictions of possible slowing as a function of ED
type. It may be the case that different ED subtypes may show differential slowing
patterns. Alternatively, slowing may not be an issue regardless of ED subtype. The
latter result would suggest that processes other than basic RT are what are result-
ing in information-processing deficits seen in these groups. Third, ED assessment
methods varied across the studies and the diagnoses of the groups above were made
using a combination of the DSM-IV and the DSM-V.
90 F. R. FERRARO ET AL.

Despite these shortcomings, our results suggest that application of the Brinley
plot analysis is useful in examining potential speed of processing slowing in ED, as
has been the case with other populations (e.g., Alzheimer’s, HIV, aging, develop-
mental disabled). Use of Brinley analysis has been helpful in other areas of research,
and we would expect the same for the ED literature. Analysis of additional studies in
the ED literature might yield different results, as compared to what we found. Like
many Brinley plot and meta-analyses, addition of different studies and changes in
criteria for including/excluding studies may alter the results. However, we again sug-
gest that use of Brinley analyses allows for the resolution of uncertainty in the liter-
ature when individual studies differ. Likewise, the General Slowing theoretical view
suggests that there is very little slowing observed in ED overall, but when task type
is examined (SRT versus CRT), the resulting slope and RT values are significantly
greater in the CRT analysis as compared to the SRT analysis. Use of this theoretical
view may allow for further study of how ED impacts RT. Future studies should con-
tinue to examine processing speed issues in ED to address some of the limitations
noted above and garner further understanding of RT among individuals diagnosed
with eating disorders. That said, it appears that there is very little RT slowing in ED
overall, but when task type (SRT, CRT) is examined it appears the ED subjects are
impacted more negatively by the CRT tasks as compared to the SRT tasks, as evi-
dence by the significantly greater slope value across the CRT tasks. Finally, from a
theoretical perspective, adaptation of Chen et al. (2016) along with further exami-
nation of RT variability may prove useful in the continued examination and interest
of RT and ED. Likewise the use of Brinley plot analysis in ED may also prove useful
in examining psychomotor and cognitive slowing in this group. Examining such RT
slowing in ED remains an important area of continued research.

References
References marked with an asterisk (∗ ) indicate studies included in the meta-analysis.
Balota, D. A., Cortese, M. J., Sergent-Marshall, S. D., Spieler, D. H., & Yap, M. J. (2004). Visual
word recognition of single-syllable words. Journal of Experimental Psychology: General, 133,
283–316. doi:10.1037/0096-3445.133.2.283
(∗ )Bartholdy, S., Rennalls, S. J., Jacques, C., Danby, H., Campbell, I. C., Schmidt, U., & O’Daly, O.
G. (2017). Proactive and reactive inhibitory control in eating disorders. Psychiatry Research,
255, 432–440. doi:10.1016/j.psychres.2017.06.073
Bashore, T. R. (1990). A3e-related changes in mental processing revealed by analysis of event-
related brain potentials. In J. W., Rohrbaugh, R. Parasuraman, & R. Johnson (Eds.), Event-
related brain potentials: Basic issues and applications (pp. 243–275). New York, NY: Oxford
University Press.
(∗ )Blechert, J., Ansorge, U., & Tuschen-Caffier, B. (2010). A body-related dot-probe task reveals
distinct attentional patterns for bulimia nervosa and anorexia nervosa. Journal of Abnormal
Psychology, 119, 575–580. doi:10.1037/a0019531
(∗ )Boisseau, C. L., Thompson-Brenner, H., Caldwell-Harris, C., Pratt, E., Farchione, T., & Barlow,
D. (2012). Behavioral and cognitive impulsivity in obsessive-compulsive disorder and eating
disorders. Psychiatry Research, 200, 1062–1066. doi:10.1016/j.psychres.2012.06.010
(∗ )Bosanac, P., Kurlender, S., Stojanvska, L., Hallam, K., Norman, T., McGrath, C. Olver, J.
(2007). Neuropsychological study of underweight and “weight-recovered” anorexia nervosa
 THE JOURNAL OF GENERAL PSYCHOLOGY 91

compared with bulimia nervosa and normal controls. International Journal of Eating Disor-
ders, 40, 613–621. doi:10.1002/eat.20412
Brinley, J. F. (1965). Cognitive sets, speed and accuracy of performance in the elderly. In A. T.
Welford, & J. E. Birren (Eds.), Behavior, aging and the nervous system (pp. 114–129). Spring-
field, IL: Charles C. Thomas.
(∗ )Butler, G. K. L., & Montgomery, A. M. J. (2005). Subjective self-control and
behavioral impulsivity coexist in anorexia nervosa. Eating Behaviors, 6, 221–227.
doi:10.1016/j.eatbeh.2004.11.002
Chen, J., Papies, E. K., & Barsolou, L. W. (2016). A core eating network and its modulation under-
lie diverse earting phenomena. Brain & Cognition, 110, 20–42.
(∗ )Claes, L., Nederkoorn, C., Vandereycken, W., Guerrieri, R., & Vertommen, H. (2006).
Impulsiveness and lack of inhibitory control in eating disorders. Eating Behaviors, 7,
196–203.
(∗ )Cooper, M. J., Anastasiades, P., & Fairburn, C. G. (1992). Selective processing of eating shape-,
and weight-related words n persons with bulimia nervosa. Journal of Abnormal Psychology,
101, 352–355. doi:10.1037/0021-843X.101.2.352
Dalmaso, M., Castelli, L., Scatturin, P., Carli, L., Todisco, P., Palomba, D., & Galfano, G.(2016).
Altered social attention in anorexia nervosa during real social interaction. Scientific Reports,
6, 1–11. doi:10.1038/srep23311
(∗ )Fassino, S., Piero, A., Daga, G. A., Leombruni, P., Mortara, P., & Rovera, G. G. (2002). Atten-
tional biases and frontal functioning in anorexia nervosa. International Journal of Eating Dis-
orders, 31, 274–283. doi:10.1002/eat.10028
Ferraro, F. R. (1996). Cognitive slowing in closed-head injury. Brain & Cognition, 32, 429–440.
doi:10.1006/brcg.1996.0075
Ferraro, F. R. (2016). Short Report: No evidence of reaction time slowing in Autism Spectrum
Disorders. Autism, 20, 116–122. doi:10.1177/1362361314559986
(∗ )Galimberti, E., Martoni, R. M., Cavallini, M. C., Erzegovesi, S., & Bellodi, L. (2011).
Motor inhibition and cognitive flexibility in eating disorder subtypes. Progress in Neuro-
Psychopharmacology and Biological Psychiatry, 10, 1–6.
(∗ )Green, M. M., McKenna, F. P., & DeSilva, M. S. (1994). Habituation patterns to colour nam-
ing in eating-related stimuli in anorexics and non-clinical controls. British Journal of Clinical
Psychology, 33, 499–508.doi:10.1111/j.2044-8260.1994.tb01146.x
(∗ )Green, M. W., Wakeling, A., Elliman, N. A., & Rodgers, P. J. (1998). Impaired colour naming of
clinically salient words as a measure of recovery in anorexia nervosa. Behavioral and Cognitive
Psychotherapy, 26, 53–62. doi:10.1017/S135246589800006X
Hardy, D. J., & Hinkin, C. H. (2002). Reaction time slowing in adults with HIV: Results
of a meta-analysis using Brinley plots. Brain & Cognition, 50, 25–34. doi:10.1016/S0278-
2626(02)00007-6
Jiang, M. Y. W., & Vartanian, L. R. (2017). A review of existing measures of attentional
biases in body image and eating disorder research. Australian Journal of Psychology, 21,
11–25.
(∗ )Johansson, L., Carlbring, P., Ghaderi, A., & Andersson, G. (2008). Emotional Stroop via inter-
net among individuals with eating disorders. Journal of Psychology, 49, 69–76.
(∗ )Jones-Chesters, M. H., Monsell, S., & Cooper, P. J. (1998). The disorder-salient Stroop effect as
a measure of psychopathology in eating disorders. International Journal of Eating Disorders,
24, 65–82. doi:10.1002/(SICI)1098-108X(199807)24:1%3c65::AID-EAT6%3e3.0.CO;2-Z
Kail, R. (1992). General slowing of information processing by persons with mental retardation.
American Journal of Mental Deficiency, 97, 331–341.
Madden, D. J., Nebes, R. D., & Allen, P. A. (1992). Cognitive slowing in Alzheimer’s disease
as a function of task type and response type. Developmental Neuropsychology, 8, 459–471.
doi:10.1080/87565649209540538
92 F. R. FERRARO ET AL.

MacDonald, S. W. S., Li, S.-C., & Backman, L. (2006). Neural underpinnings of within-person
variability in cognitive functioning. Psychology & Aging, 24, 792–808. doi:10.1037/a0017798
(∗ )Mendlewicz, L., Nef, F., & Simon, Y. (2001). Selective handling of information in patients suf-
fering from restrictive anorexia in an emotional Stroop test and a word recognition test. Neu-
ropsychobiology, 44, 59–64. doi:10.1159/000054916
Meiran, N., Levine, J., Meiran, N., & Henik, A. (2000). Task set switching in Schizophrenia. Neu-
ropsychology, 14, 471. doi:10.1037/0894-4105.14.3.471
Myers, T. A., Ridolfi, D. R., & Crowther, J. H. (2015). Reaction times to appearance-related or non-
appearance-related word choice among women with and without eating psychopathology.
Cognitive Therapy & Research, 39, 204–214. doi:10.1007/s10608-014-9653-5
Myerson, J., Adams, D., Hale, S., & Jenkins, L. (2003). Analysis of group differences in processing
speed: Brinley plots, Q-Q plots, and other conspiracies. Psychonomic Bulletin & Review, 10,
224–237. doi:10.3758/BF03196489
(∗ )Nikendei, C., Weisbrod, M., Schild, S., Bender, S., Walther, S., Herzog, W., Zipfel, S., & Friedr-
ish, H. C. (2008). Anorexia nervosa: Selective processing of food-related word and picto-
rial stimuli in recognition and free recall tests. International Journal of Eating Disorders, 41,
439–447. doi:10.1002/eat.20518
(∗ )Pieters, G. L. M., de Bruijn, E. R. A., Maas, Y., Hulstijn, W., Vandereycken, W., Peuskens, J.,
& Sabbe, B. G. (2007). Action monitoring and perfectionism in anorexia nervosa. Brain &
Cognition, 63, 42–50. doi:10.1016/j.bandc.2006.07.009
(∗ )Pieters, G., Hulstijn, W., Vandereycken, W., Maas, Y., Probst, M., Peuskens, J., &
Sabbe, B. (2005). Fast psychomotor functioning in anorexia nervosa: Effect of weight
restoration. Journal of Clinical and Experimental Neuropsychology, 27, 931–942.
doi:10.1080/13803390490918093
(∗ )Pieters, G., Sabbe, B., Hulstijn, W., Probst Vandereycken, W., & Peuskens, J. (2003). Fast
psychomotor functioning in underweight anorexia nervosa patients. Journal of Psychiatric
Research, 37, 501–508. doi:10.1016/S0022-3956(03)00067-0
Pocklington, B., & Maybery, M. (2006). Proportional slowing or disinhibition in ADHD? A Brin-
ley plot meta-analysis of Stroop color and word test performance. International Journal of
Disability, Development and Education, 53, 657–691. doi:10.1080/10349120500510057
(∗ )Schober, I., Renwick, B., de Johg, H., Kenyon, M., Sharpe, H., Jacobi, C., & Schmidt, U. (2014).
Threat-related attentional bias in anorexia nervosa. International Journal of Eating Disorders,
47, 168–173. doi:10.1002/eat.22215
(∗ )Smeets, E., Roefs, A., Van, F. E., & Jansen, A. (2008). Attentional bias for body and food in
eating disorders: Increased distraction, speeded detection or both?. Behavioral Research &
Therapy, 46, 229–238. doi:10.1016/j.brat.2007.12.003
(∗ )Smith, A. R., Joiner, T. E., & Dodd, D. R. (2014). Examining implicit attitudes toward emacia-
tion and thinness in anorexia nervosa. International Journal of Eating Disorders, 47, 138–147.
doi:10.1002/eat.22210
Sternberg, S. (1969). The discovery of processing stages: Extensions of Donders’ method. In W.
G. Koster (Ed.), Attention and performance (Vol. 2). Amsterdam: North Holland Press.
(∗ )Stormark, K. M., & Torkildsen, O. (2004). Selective processing of linguistic and pic-
torial food stimuli in females with anorexia nervosa. Eating Behaviors, 5, 27–33.
doi:10.1016/j.eatbeh.2003.07.002
Verhaegen, P., & Cerella, J. (2002). Aging, executive control, and attention: A review of
meta-analyses. Neuroscience & Biobehavioral Review, 26, 849–857. doi:10.1016/S0149-
7634(02)00071-4
(∗ )Wu, M., Giel, K. E., Skunde, M., Schag, K., Rudofsky, G., Zwaan, M. … Friederich, H-C. (2013).
Inhibitory control and decision-making under risk in bulimia nervosa and binge-eating dis-
order. International Journal of Eating Disorders, 46, 721–728. doi:10.1002/eat.22143