Empathy, mentalizing, and cognitive functioning in anorexia nervosa and bulimia nervosa

Konstantakopoulos, George; Ioannidi, N.; Patrikelis, Panayiotis; Gonidakis, Fragiskos

doi:10.1080/17470919.2020.1760131

Cited by 21 publications

(24 citation statements)

References 48 publications

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“…The concept of empathy includes the identification of another's mental state and the appropriate response to their mental state [30]. Abnormalities in empathy have been reported in various psychiatric disorders [31][32][33]. Individuals with ASD have repeatedly been reported to show impairments in empathy across the life span relative to typical controls [30,34] and in their ability to maintain selective attention when it concerns emotional stimuli [35].…”

Section: Introductionmentioning

confidence: 99%

Trait-Based Dimensions Discriminating Adults with Attention Deficit Hyperactivity Disorder (ADHD), Autism Spectrum Disorder (ASD) and, Co-occurring ADHD/ASD

et al. 2020

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This study assessed the co-occurrence of attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) in newly diagnosed adults of normal intelligence and the contribution of trait-based dimensions deriving from the Barkley Adult ADHD Rating Scale-IV (BAARS-IV), the Autism-Spectrum Quotient (AQ), and the Empathy Quotient (EQ) to the differentiation of patients with ADHD, ASD, and ADHD/ASD. A total of 16.1% of patients with ADHD received a co-occurring ASD diagnosis, while 33.3% of patients with ASD received an ADHD diagnosis. Subjects with ADHD or ADHD/ASD had higher scores in all ADHD traits compared to ASD subjects. Compared to the ADHD group, the ASD group had AQ scores that were significantly greater, except for attention to detail. ADHD/ASD co-occurrence significantly increased the score of attention to detail. The total EQ score was greater in the ADHD group. In the stepwise logistic regression analyses, past hyperactivity, current inattention and impulsivity, attention switching, communication, imagination, and total EQ score discriminated ADHD patients from ASD patients. Attention to detail, imagination, and total EQ score discriminated ADHD cases from ADHD/ASD cases, while past hyperactivity and current impulsivity discriminated ASD subjects from ADHD/ASD subjects. Our findings highlight the importance of particular trait-based dimensions when discriminating adults with ADHD, ASD, and co-occurring ADHD/ASD.

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Section: Introductionmentioning

confidence: 99%

Trait-Based Dimensions Discriminating Adults with Attention Deficit Hyperactivity Disorder (ADHD), Autism Spectrum Disorder (ASD) and, Co-occurring ADHD/ASD

et al. 2020

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“…Overall, as expected, we observed group differences for third party ratings of pleasantness of touch for self but not for another. We capitalized on prior research which has reported that individuals with AN have impaired ToM which involves the decoding of affective stimuli [38] both at self and other perspectives [36,37] and it was found to manifest even after recovery [39,40,41,42,43,44,81]. In this study, it was expected that anorexics would use their own experiences to interpret the feelings generated in another, which would be less pleasant compared to neurotypical populations.…”

Section: Discussionmentioning

confidence: 99%

“…Participants classified as highly empathetic, had higher mu suppression and rated social touch as more pleasant, as opposed to participants reporting lower empathy levels. Therefore, it would be prudent in future studies that involve third-party ratings of touch, rather than actual touch, to consider empathy measures, as responses to observed touch are modulated by empathy levels and previous research has found that current anorexics have lower levels of empathy compared to RAN and HCs [41,97].…”

Section: Discussionmentioning

confidence: 99%

“…One important aspect of ToM is cognitive perspective taking which is one's capacity to compare state of self (1 st person perspective) with another individual (3 rd person perspective), with both perspectives involving different neural and cognitive processes [36,37]. It is well known that anorexics have difficulties in attributing mental states (intentions, feelings, beliefs) to others and in explaining and predicting others' behaviour, which involves the decoding of affective stimuli [38,39,40,41,42,43,44]. Further, fMRI studies have revealed that even after recovery, anorexics have reduced functioning in social and cognitive networks, compared to healthy controls, which again can account for their difficulty in ToM perspective taking [38,45].…”

Section: Introductionmentioning

confidence: 99%

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Vicarious Ratings of Self vs. Other-directed Social Touch in Women with and Recovered from Anorexia Nervosa

Bellard¹,

Trotter²,

McGlone³

et al. 2021

Preprint

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Anorexia Nervosa (AN) is an eating pathology characterized by restricted eating, body image distortions and impaired socio-cognitive abilities. Altered responses to affective touch − a pleasant interoceptive stimulus hypothesised to involve activation of the C-Tactile (CT) system, may contribute to the aetiology and maintenance of this disorder. Here, we investigated whether third-party social touch vicarious ratings of different body sites at CT-optimal vs. non-CT optimal velocities differed in women with and recovered from AN (RAN) and healthy controls (HCs). Thirty-five HCs, 27 AN and 29 RAN provided pleasantness ratings for two different tasks designed to probe expectations of how touch is perceived by self (self-directed touch) vs. others (other-directed touch). Findings revealed that both clinical groups, compared to HCs, did not differ in their pleasantness ratings to touch for another but when evaluating touch for self, both clinical groups rated CT-optimal touch as less pleasant than HCs. These findings suggest that AN and RAN women demonstrate an atypical vicarious pleasantness response to affective touch involving self, but not others. Therefore, as atypical responses persist even after recovery, treatment interventions should focus on overcoming an impairment in differentiating between self and other affective touch experience, which could help prevent post-recovery relapsing.

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“…A range of studies have confirmed the presence of alexithymia among obese patients [e.g., 69], although there is substantial variation in which alexithymia subscales are affected in obesity. Patients with EDs show limited ability to identify and process facial emotions [70] and experience difficulty showing empathy which requires understanding the emotional state in others [71]. There are similarities between the cognitive dysfunction in EDs and obesity [72].…”

Section: Introductionmentioning

confidence: 99%

Obese Adolescents Have Reduced Mentalizing Ability

Taheri¹,

Mazaheri²,

Zabihzadeh³

et al. 2021

Preprint

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Purpose: Obesity affects both mental health and the quality of life, and it also causes diseases associated with increased mortality. The aetiology of obesity is thought to be multifactorial with biological, psychological and social elements. The psychological realm includes the capacity to be aware of one’s own and others’ mental states, that is mentalizing. We hypothesized that poor mentalizing might contribute to the development and/or persistence of obesity among adolescents. The present study aims to investigate the components of the mentalization model to better identify the psychological status of obese adolescents. Methods: This study was carried out on 100 adolescent girls aged 15 to 19 years who were either obese (N=50, Mean age=17.04, Mean BMI=30.24) or normal weight (N=50, Mean age=16.94, Mean BMI=20.95). All completed the reflective functioning questionnaire (RFQ), reading the mind in the eyes test (RMET), difficulties in emotional regulation scale (DERS), and Toronto alexithymia scale (TAS). Results: Multivariate analysis of variance, univariate analysis of variance, and independent t-test were used. Lower certainty and higher uncertainty on the RFQ were confirmed in the OB group indicating reduced mentalizing ability. Misperception and misinterpretation of emotional states conveyed in the eyes in the RMET were consistent the RFQ results. Alexithymia, including difficulty recognizing, expressing and reflecting on emotions, was also found and this also fits with poor mentalizing capacity. The OB group had difficulty in all components of DERS, apart from the “Strategies” subscale. Conclusion: Mentalization or reflective function is significantly poorer in obese, compared to normal weight adolescents. Poor mentalizing could be a cause of obesity, a factor leading to its persistence, or a consequence of obesity. Further research is required to differentiate these possibilities.Level of evidence Level III: case-control analytic study.

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Empathy, mentalizing, and cognitive functioning in anorexia nervosa and bulimia nervosa

Cited by 21 publications

References 48 publications

Trait-Based Dimensions Discriminating Adults with Attention Deficit Hyperactivity Disorder (ADHD), Autism Spectrum Disorder (ASD) and, Co-occurring ADHD/ASD

Trait-Based Dimensions Discriminating Adults with Attention Deficit Hyperactivity Disorder (ADHD), Autism Spectrum Disorder (ASD) and, Co-occurring ADHD/ASD

Vicarious Ratings of Self vs. Other-directed Social Touch in Women with and Recovered from Anorexia Nervosa

Obese Adolescents Have Reduced Mentalizing Ability

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