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While a diagnosis of AN implies severe levels of impairment, AN traits can vary on a continuum within the population. However, little is known about how early markers of AN relate to rigid thought patterns and to what extent cognitive rigidity is already present in early childhood. We examined the association of set\u2010shifting abilities as a measure of cognitive flexibility in preadolescents with AN\u2010related features.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Participants included 3,987 children participating in the Generation R Study, a Dutch population\u2010based birth cohort. Set\u2010shifting abilities (mother report) were assessed at 4\u2009years of age, body mass index (BMI) was determined at 4 and 9\u2009years and restrictive eating patterns (mother report) and body image (child report) were assessed at 9\u2009years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Lower set\u2010shifting abilities at 4\u2009years were associated with a lower BMI (<jats:italic>\u03b2<\/jats:italic>\u00a0=\u2009\u2212.44, <jats:italic>p<\/jats:italic>\u00a0=\u20092.2\u00a0\u00d7\u200910<jats:sup>\u22124<\/jats:sup>) in girls, and more restrictive eating (<jats:italic>\u03b2<\/jats:italic>\u00a0=\u20090.15, <jats:italic>p<\/jats:italic>\u00a0=\u20092.7\u00a0\u00d7\u200910<jats:sup>\u22126<\/jats:sup>) in both boys and girls at 9\u2009years of age. Moreover, set\u2010shifting at age 4 was not associated with body image at age 9.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>These findings contribute to the idea that the association between set\u2010shifting problems and AN\u2010related features are present early in childhood, prior to the typical range of the onset of eating disorders (EDs). Longitudinal studies that capture the peak age for the development of EDs will be important to assess whether early cognitive inflexibility is an early marker of AN.<\/jats:p><\/jats:sec>","DOI":"10.1002\/eat.23633","type":"journal-article","created":{"date-parts":[[2021,10,30]],"date-time":"2021-10-30T10:05:14Z","timestamp":1635588314000},"page":"2180-2191","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["The longitudinal relationship between set\u2010shifting at 4\u2009years of age and eating disorder related features at 9\u2009years of age in the general pediatric population"],"prefix":"10.1002","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7306-1101","authenticated-orcid":false,"given":"Cathelijne","family":"Steegers","sequence":"first","affiliation":[{"name":"Department of Child and Adolescent Psychiatry\/Psychology Erasmus MC\u2010Sophia Children's Hospital  Rotterdam The 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