Differences in the Theory of Mind profiles of patients with anorexia nervosa and individuals on the autism spectrum: A meta-analytic review

Leppänen, Jenni; Sedgewick, Felicity; Treasure, Janet; Tchanturia, Kate

doi:10.1016/j.neubiorev.2018.04.009

Cited by 79 publications

(73 citation statements)

References 142 publications

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“…Potential mechanisms underlying the relationship between AN and autism could include shared cognitive traits: commonly with research in autism, literature shows that people with AN exhibit problems with rigidity, central coherence, and emotional and social processing that may persist following recovery (Harrison, Mountford, & Tchanturia, 2014;Lang, Lopez, Stahl, Tchanturia, & Treasure, 2014;Katie Lang et al, 2016;Leppanen, Sedgewick, Treasure, & Tchanturia, 2018;Westwood, Lawrence, Fleming, & Tchanturia, 2016;Westwood, Stahl, Mandy, & Tchanturia, 2016). Significantly, heightened autistic traits in people with AN are associated with more severe presentations and poorer treatment outcomes (Nielsen, Anckarsater, Gillberg, Rastam, & Wentz, 2015;Tchanturia, Adamson, Leppanen, & Westwood, 2017;Tchanturia, Larsson, & Adamson, 2016), leading to suggestions that traditional treatment approaches may need to be adapted for this population (Dudova, Kocourkova, & Koutek, 2015;Stewart, McEwen, Konstantellou, Eisler, & Simic, 2017;.…”

Section: Introductionmentioning

confidence: 99%

Same behaviours, different reasons: what do patients with co-occurring anorexia and autism want from treatment?

Kinnaird

Norton

Stewart

et al. 2019

International Review of Psychiatry

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Key words: Qualitative, Autism, anorexia, treatment, comorbidityResearch suggests that up to 1 in 4 individuals with anorexia nervosa (AN) may be on the autistic spectrum, and that these autistic traits may not have been recognised or diagnosed prior to eating disorder (ED) treatment. Significantly, these heightened autistic traits are associated with poorer treatment outcomes, suggesting that treatment may need to be adapted for this population. The purpose of this study was to explore with people with AN on the autistic spectrum their experiences of ED treatment, and their views on what needs to be changed. Women with AN (n= 13) either with an autism diagnosis, or presenting with clinically significant levels of autistic traits, were interviewed on their experiences of treatment and potential improvements. Interviews were analysed using thematic analysis. The findings suggest that this population experience unique needs associated with their autism that are not being met by standard ED treatments, and recommendations are made for potential future adaptations. Future research into a more systematic approach for treatment adaptations for this population, including education programmes for clinicians, could potentially lead to better treatment experiences.

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Section: Introductionmentioning

confidence: 99%

Same behaviours, different reasons: what do patients with co-occurring anorexia and autism want from treatment?

Kinnaird

Norton

Stewart

et al. 2019

International Review of Psychiatry

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“…Several lines of evidence suggest that social‐affective difficulties, when present in individuals with AN, may differ from those documented in individuals with autism (Leppanen, Sedgewick, Treasure, & Tchanturia, 2018). This finding supports the possibility that a different set of ADOS‐2 items than those forming the existing algorithm might be better suited to describe these difficulties.…”

Section: Introductionmentioning

confidence: 99%

“…First, inefficiencies of social perception and Theory of Mind tend to be elevated among adults, but not in adolescents with AN (Caglar‐Nazali et al, 2014; Leppanen et al, 2018). Second, a meta‐analytic review found that individuals with AN and individuals with autism exhibit different profiles of difficulties with Theory of Mind (Leppanen et al, 2018). Third, using the ADOS‐2, a study found a significant difference between adolescents with AN and HCs on three ADOS‐2 items, which are not part of the existing algorithm (the items ‘Offers information’, ‘Reporting of events’, and ‘Amount of Social Overtures’; Bentz et al, 2017).…”

Section: Introductionmentioning

confidence: 99%

The autism diagnostic observation schedule: Patterns in individuals with anorexia nervosa

Bentz

Westwood

Jepsen

et al. 2020

Euro Eating Disorders Rev

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Objective Studies have used the Autism Diagnostic Observation Schedule (the ADOS‐2) in individuals with anorexia nervosa (AN), but the patterns of scores have not been assessed. We examined which subset of the ADOS‐2 items best discriminate individuals with AN from healthy controls (HC), and assessed the potential clustering of AN participants based on different profiles of the ADOS‐2 item scores. Method We combined datasets from two previous studies, and (a) compared mean ranks between young AN participants (N = 118) and HC (N = 42), (ii) replicated the item selection procedure of the existing ADOS‐2 algorithm to assess sensitivity of items in the AN group, and (c) applied a two‐step clustering analysis in the AN group (N = 149). Results AN participants displayed significantly higher mean ranks than HC participants in five of 32 items. All five items are part of the existing ADOS‐2 algorithm. We found two clusters of AN participants; one representing normal social behaviour, comprising 68% of the individuals with AN, and one representing less efficient social behaviour, comprising 32% of individuals with AN. Conclusions The items comprising the social affective cluster of the existing ADOS‐2 algorithm are well suited to assess difficulties with social functioning in individuals with AN.

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“…Consequently, there is an increasing interest in exploring characteristics associated with autism that may play a role in maintenance models of AN, contributing to these poorer outcomes. For example, previous studies have investigated similarities in cognitive rigidity and theory of mind difficulties in AN and autism, both of which are thought to act as potential perpetuating factors in the illness [8][9][10]. To date, there is less research on the implications of sensory sensitivity in autism for AN.…”

Section: Introductionmentioning

confidence: 99%

The relationship of autistic traits to taste and olfactory processing in anorexia nervosa

2020

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Background: There is a heightened prevalence of autism in anorexia nervosa (AN) compared to the general population. Autistic people with AN experience a longer illness duration and poorer treatment outcomes. Whether sensory differences in autism could contribute to altered taste and smell as a potential maintaining factor in AN is under-explored. The aim of this study was to explore whether autistic traits are associated with taste and olfaction differences in AN. Methods: The study recruited n = 40 people with AN, and n = 40 healthy controls (HC). Smell sensitivity was measured using the Sniffin' Sticks test. Taste sensitivity was measured using taste strips. Participants self-rated their autistic traits using the Autism Spectrum Quotient. Results: There were no significant differences on taste and olfactory outcomes between people with AN and HC. These findings did not change after controlling for the heightened levels of autistic traits in the AN group. No relationship between taste and smell outcomes and autistic traits were identified within the AN group. Limitations: The current study is not able to draw conclusions about taste and smell processing in co-occurring autism and AN as it only measured levels of autistic traits, rather than comparing people with and without an autism diagnosis. Conclusions: No significant associations between autistic traits and taste and smell processing in AN were identified. Future research should consider further exploring this area, including by comparing autistic women to women with AN.

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Differences in the Theory of Mind profiles of patients with anorexia nervosa and individuals on the autism spectrum: A meta-analytic review

Cited by 79 publications

References 142 publications

Same behaviours, different reasons: what do patients with co-occurring anorexia and autism want from treatment?

Same behaviours, different reasons: what do patients with co-occurring anorexia and autism want from treatment?

The autism diagnostic observation schedule: Patterns in individuals with anorexia nervosa

The relationship of autistic traits to taste and olfactory processing in anorexia nervosa

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