Unna Danner

Contact Information

Location:
Altrecht Eating Disorders Rintveld
Wenshoek 4
3705 WE Zeist

Tel: +31 (0)30 696 5477
E-mail: U.Danner@altrecht.nl

Introduction

In 2007 I obtained my PhD degree from the department of Social Psychology of Utrecht University. The focus of my PhD research was on cognitive processes underlying habitual behavior and in particular the role of inhibitory processes. Since I have always been interested in health related behavior, I happily accepted a position as PostDoc at Altrecht Eating Disorders Rintveld, part of Altrecht Mental Health Institute from 2007-2010. This was a collaboration with the department of Clinical and Health Psychology of Utrecht University. As part of my PostDoc position I supervised several Bachelor and Master theses and was involved in different courses. Since August 2010 I am working fulltime as a senior researcher at Altrecht Eating Disorders Rintveld. In addition to my own research, I coordinate the scientific projects at Altrecht Eating Disorders Rintveld, supervise master students in their thesis projects, and together with Annemarie van Elburg I focus on the translation of scientific findings to clinical practice. In addition, I am actively involved in the Academy for Eating Disorders (AED scientific committee) and Committee Scientific Research (CWO) of Altrecht Mental Health Institute.

Research

The focus of my research in the past years was on the (neuro)cognitive functioning of patients with eating disorders. I am interested in the inflexible nature of patients with eating disorders as can be observed in their tendency to focus strongly on details (referring to weak central coherence) and difficulties changing behavior or multitasking (referring to impaired set shifting). So eating disordered patients are not only inflexible in their behavior and cognition, but also in their way of thinking, i.e. thinking styles. Since not all patients with eating disorders have an inflexible thinking style, I find it important to also examine relations with specific traits such as impulsivity. Having an inflexible thinking style, makes it difficult for patients to optimally profit from treatment. We therefore also examined a treatment module, Cognitive Remediation Therapy (CRT), aimed to improve this thinking style. Together with Alexandra Dingemans from the Center for Eating Disorders Ursula, I did a first randomized controlled trial to test the influence of CRT on the neurocognitive functioning of patients with chronic eating disorders (AN and BN). Results from this study led to the second RCT into the (cost)effectiveness of CRT for anorexia nervosa and obsessive-compulsive disorder in collaboration with Danielle Cath from the Altrecht Academic Anxiety center. We received a ZonMw Health care efficiency research grant and the study is currently running in Rintveld, Altrecht Anxiety, Ursula Eating Disorders and Overwaal Anxiety center (first results are expected in Spring 2016). An other (cognitive) topic I am interested in is impaired decision making ability of patients with eating disorders. This is most apparent in their eating behavior (not eating while having severe low weight), but is often also visible in other behaviors: Patients displaying binge-purge behaviors often also show comorbid substance abuse, self-harm or suicidal behavior, but also other behaviors such as risky financial or sexual behavior can be the result of difficulties making adequate decisions. Affective processes are important for adequate decision making, in particular in more complex situations and/or under uncertain conditions. Patients with eating disorders are known to have disturbances in their affective system and to have difficulties feeling, recognizing and regulating (negative) emotions. I therefore ran a few experiments aimed to test the influence of negative affect on decision making ability of patients with all types of eating disorder. I think it is important to consider the role of affect when studying decision making processes in individuals with eating disorders. In the future I hope to test if treatment modules aimed at improving emotion regulation skills will improve decision making ability. My interest in neurocognitive functioning is not limited to eating disorders. I am also involved in a large EU funded project, I.Family, with the aim to investigating the determinants of food choice, lifestyle and health in European children, adolescents and their parents. My role is this project is to examine neuropsychological profiles of children, adolescents and their parents and the relationship with different eating behaviors and, together with Roger Adan, with genetic polymorphisms. Since March Juul Coumans joined our team and she is now analyzing the results. For more information on this interesting project: http://www.ifamilystudy.eu/project-information/

Publications

• Hyperactivity in anorexia nervosa: Warming up not just burning-off calories.
• Neuropsychological weaknesses in anorexia nervosa: set-shifting, central coherence, and decision making in currently ill and recovered women.
• Influence of negative affect on choice behavior in individuals with binge eating pathology.
• The effectiveness of cognitive remediation therapy in patients with a severe or enduring eating disorder: a randomized controlled trial.
• Differential impairments underlying decision making in anorexia nervosa and bulimia nervosa: a cognitive modeling analysis.
• The importance of distinguishing between the different eating disorders (sub)types when assessing emotion regulation strategies.
• Drive for activity in patients with anorexia nervosa.
• Altered food-cue processing in chronically ill and recovered women with anorexia nervosa.
• Mental capacity to consent to treatment in anorexia nervosa: explorative study.
• Cognitive remediation therapy for eating disorders.
• Influence of negative affect on decision making in women with retrictive and binge-purge type anorexia nervosa.
• Rate, timing and predictors of relapse in patients with anorexia nervosa following a relapse prevention program: a cohort study.
• Development and Validation of a Decision Tool for Early Identification of Adult Patients with Severe and Complex Eating Disorder Psychopathology in Need of Highly Specialized Care
• Decision-making impairments in women with binge eating disorder in comparison with obese and normal weight women.
• Insensitivity to Losses: A Core Feature in Patients With Anorexia Nervosa?
• Screening for Binge Eating Disorder in people with obesity.
• Disordered eating in three different age groups in Cyprus: a comparative cross-sectional study.
• Assessment of mental capacity to consent to treatment in anorexia nervosa: A comparison of clinical judgment and MacCAT-T and consequences for clinical practice.
• Analysis of shared heritability in common disorders of the brain.
• Intellectual functioning of adolescent and adult patients with eating disorders.
• Emotion Regulation in Binge Eating Disorder: A Review.
• Mental capacity to consent to treatment and the association with outcome: a longitudinal study in patients with anorexia nervosa
• Associations between neural correlates of visusal stimulus processing and set-shifting in ill and recovered women with anorexia nervosa.
• Cognitive remediation therapy (CRT) as a treatment enhancer of eating disorders and obsessive compulsive disorders: study protocol for a randomized controlled trial.
• Compulsory treatment in anorexia nervosa: A review.
• A double burden: Emotional eating and lack of cognitive reappraisal in eating disordered women.
• The Eating Disorder Diagnostic Scale: psychometric features within a clinical population and a cut-off point to differentiate clinical patients from healthy controls.
• The shaping role of hunger on self-reported external eating status.
• Genome-wide association study identifies eight risk loci and implicates metabo-psychiatric origins for anorexia nervosa.
• The association of emotion-driven impulsiveness, cognitive inflexibility and decision-making with weight status in European adolescents.

Click here to view my articles on pubmed.