Exploring Self-Reported Eating Disorder Symptoms in Autistic Men

Kinnaird, Emma; Sedgewick, Felicity; Stewart, Catherine; Tchanturia, Kate

doi:10.1089/aut.2019.0017

Cited by 6 publications

(7 citation statements)

References 27 publications

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“…The bootstrapping method is generally robust to violations of normality and suited to small sample sizes [107,147], so the possibility that relationships between autistic traits, eating psychopathology, and alexithymia do differ in males is still plausible until replicated in a larger sample. This interpretation is bolstered by recent, yet unpublished data from the Tchanturia group, who examined eating psychopathology in autistic men [148]. Though significant relationships between the subscales of the Eating Disorder Examination Questionnaire (EDE-Q) and the AQ-short were seen, regression revealed that anxiety and BMI fully explained the variance in eating, shape, or weight concern, where autistic traits did not.…”

Section: Moderators and Covariates In The Aq-(tas-20)-eat-26 Relationmentioning

confidence: 96%

“…In their unpublished study of eating psychopathology in autistic men, Kinnaird et al [148] highlight anxiety as a putative mechanism of importance; as this most consistently predicted scores on the EDE-Q, the authors speculate that anxiety might be a risk factor that increases autistic vulnerability to eating disorders. The importance of anxiety as "one developmental pathway" to AN [150] has been recognized in nonautistic people-but just as with alexithymia, malnutrition in individuals with disordered eating makes it difficult to decipher any pathogenic role of anxiety or depression.…”

Section: Anxiety and Depressionmentioning

confidence: 99%

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Alexithymia may explain the relationship between autistic traits and eating disorder psychopathology

et al. 2020

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Background: Autistic people are disproportionately vulnerable to anorexia nervosa and other eating disorders (ED), and within the general population, autistic traits correlate with ED psychopathology. A putative mechanism which may underpin this heightened risk is alexithymia, a difficulty identifying and describing emotional states which is observed in both autism and ED. In two experiments with independent non-clinical samples, we explored whether alexithymia might mediate the heightened risk of eating psychopathology in individuals high in autistic traits. Methods: Our first experiment used the PROCESS macro for SPSS to examine relationships between alexithymia (measured by the Toronto Alexithymia Scale (TAS-20)), autistic traits (autism quotient (AQ)), and eating psychopathology (Eating Attitudes Test (EAT-26)) in 121 participants. Our second experiment (n = 300) replicated and furthered this analysis by examining moderating effects of sex and controlling for anxiety and depression as covariates. We also included an additional performance-based measure of alexithymia, the Levels of Emotional Awareness Scale (LEAS). Results: Study 1 suggested that TAS-20 scores mediated the relationship between heightened autistic traits and eating psychopathology. Replication and further scrutiny of this finding, in study 2, revealed that this mediation effect was partial and specific to the female participants in this sample. The mediation effect appeared to be carried by the difficulty identifying feelings subscale of the TAS-20, even when depression and anxiety were controlled for. LEAS scores, however, were not significantly related to autistic traits or eating psychopathology. Limitations: Cross-sectional data prevents any conclusions around the direction and causality of relationships between alexithymia, autistic traits, and eating psychopathology (alongside depression and anxiety), necessitating longitudinal research. Our non-clinical sample was predominantly Caucasian undergraduate students, so it remains to be seen if these results would extrapolate to clinical and/or autistic samples. Divergence between the TAS-20 and LEAS raises crucial questions regarding the construct validity of these measures. Conclusions: Our findings with respect to autistic traits suggest that alexithymia could partially explain the prevalence of ED in autistic people and may as such be an important consideration in the pathogenesis and treatment of ED in autistic and non-autistic people alike. Further research with clinical samples is critical to explore these ideas. Differences between men and women, furthermore, emphasize the importance of looking for sexspecific as well as generic risk factors in autistic and non-autistic men and women.

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Section: Moderators and Covariates In The Aq-(tas-20)-eat-26 Relationmentioning

confidence: 96%

Section: Anxiety and Depressionmentioning

confidence: 99%

Alexithymia may explain the relationship between autistic traits and eating disorder psychopathology

et al. 2020

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“…Recently, increased attention has been directed at the overlap of autism and eating disorders, with particular emphasis on AN (e.g. Karjalainen et al, 2019 ; Kinnaird et al, 2019 ; Westwood & Tchanturia, 2017 ). Westwood and colleagues (2018) found an overrepresentation of autism symptoms in adolescent females with severe AN, with 10% of their sample meeting full criteria for autism and an additional 40% who were below cut-off but presented with symptoms.…”

Section: Feeding and Eating Problems In Persons With Autismmentioning

confidence: 99%

Feeding and eating problems in children and adolescents with autism: A scoping review

Baraskewich

Ranson

McCrimmon

et al. 2021

Autism

109

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Feeding problems, such as picky eating and food avoidance, are common in youth with autism. Other feeding and eating problems (e.g. disordered eating, fear of trying new foods, and insistence on specific food presentation) are also common in this population. This scoping review describes the nature and extent of feeding and eating problems in autistic youth and reports characteristics of autistic youth who experience such issues. Thirty-four studies were included in the current review, with almost all studies (91%) investigating feeding problems. Only 9% of studies examined concern with weight, shape, and/or body image, but several authors noted that disordered eating attitudes and behaviors may occur more frequently in those with autism than their peers without autism. No common individual characteristics (e.g. cognitive functioning and autism symptom severity) were identified for youth who experience feeding or eating problems. Although differentiating “feeding” from “eating” problems is critical for accurate identification and treatment of these issues, the existing literature has failed to do so. We propose that in future research “eating problems” be used when behaviors involve preoccupation with food, eating, or body image, and “feeding problems” be used when such preoccupation is absent. Lay abstract Feeding problems, such as picky eating and food avoidance, are common in youth with autism. Other, broader difficulties with feeding and eating (eating disorder symptoms such as restricting food intake or preoccupation with body shape or weight and insistence on specific food presentation) are also common in autistic individuals. Here, we describe the nature and extent of feeding and eating problems in youth with autism. We found no common characteristics (such as severity of autism symptoms) that best describe autistic youth who experience problems with feeding or eating. Almost all studies we reviewed focused on problems with feeding (selective or picky eating), and only a few studies focused on eating disorder symptoms (concern with weight, shape, and/or body image). However, some researchers reported that eating disorder symptoms may occur more often in autistic individuals compared to their peers without autism. Many studies used the terms “feeding” and “eating” problems interchangeably, but understanding the difference between these problems is important for researchers to be consistent, as well as for proper identification and treatment. We suggest future researchers use “eating problems” when behaviors involve preoccupation with food, eating, or body image, and “feeding problems” when this preoccupation is absent. We highlight the importance of understanding whether feeding or eating problems are separate from autism traits, and the role of caregivers and other adults in the child’s treatment. Considerations for health-care providers to assist with diagnosis and treatment are also provided.

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“…This is particularly relevant given the overrepresentation of gender-diverse and transgender people within the autistic community [ 60 – 62 ]. Additionally, there has been a historical lack of research into ED in men [ 63 , 64 ] and research suggests that autistic men may also experience higher levels of non-restrictive ED symptoms [ 65 ]. Similarly, by focussing on women with AN, our data do not extend to other types of ED although we predict many of the recommendations would be applicable.…”

Section: Discussionmentioning

confidence: 99%

“Work WITH us”: a Delphi study about improving eating disorder treatment for autistic women with anorexia nervosa

et al. 2023

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Background There is an increased prevalence of anorexia nervosa (AN) in autistic women and this group has poorer treatment outcomes compared to non-autistic women with AN. However, there is little research into improving eating disorder treatment for autistic women. This study investigated how best to support autistic women with AN within eating disorder services. Method A three-stage Delphi study was conducted with 49 participants with relevant expertise as a researcher, clinician, or expert by experience. Results A total of 70 statements were generated, with 56 reaching consensus after the final round. Statements reaching consensus made recommendations for adaptations to treatment, staff training, and service organisation. Conclusions The results highlight the need to distinguish between autism- and AN-related difficulties, accommodate autistic traits such as sensory sensitivities and communication differences, and ensure the autistic voice is present in both the development and delivery of care. Future research should investigate the impact of these adaptations on outcomes. The applicability of these recommendations to autistic people with other eating disorders and of other genders needs to be investigated further.

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Exploring Self-Reported Eating Disorder Symptoms in Autistic Men

Cited by 6 publications

References 27 publications

Alexithymia may explain the relationship between autistic traits and eating disorder psychopathology

Alexithymia may explain the relationship between autistic traits and eating disorder psychopathology

Feeding and eating problems in children and adolescents with autism: A scoping review

“Work WITH us”: a Delphi study about improving eating disorder treatment for autistic women with anorexia nervosa

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