Neural Correlates of Theory of Mind Are Preserved in Young Women With Anorexia Nervosa

Leslie, Monica; Halls, Daniel; Leppänen, Jenni; Sedgewick, Felicity; Smith, Katherine A.; Hayward, Hannah; Lang, Katie; Fonville, Leon; Simic, Mima; Mandy, William; Nicholls, Dasha; Murphy, Declan; Williams, Steven; Tchanturia, Kate

doi:10.3389/fpsyg.2020.568073

Cited by 18 publications

(30 citation statements)

References 39 publications

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“…Data were extracted from three existing data sets. AN, REC, and TD participants were from two studies investigating social and emotional functioning in AN [ 28 , 42 ], while participants with ASD were from the European Autism Interventions Longitudinal European Autism Project (EU-AIMS LEAP) [ 43 ]. Details regarding participant recruitment for the original studies can be found in the Additional file 1 .…”

Section: Methodsmentioning

confidence: 99%

Autism symptoms in anorexia nervosa: a comparative study with females with autism spectrum disorder

et al. 2021

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Background Recent research suggests a link between autism spectrum disorder (ASD) and anorexia nervosa (AN). Individuals with AN show high scores on measures of ASD symptoms, relative to individuals without AN, however, there are currently no studies directly comparing women with AN to women with ASD. The aim of the current study was to examine profiles of ASD symptoms in young women in the acute and recovered stages of AN, women with ASD, and typically developing controls (TD), on both self-report and clinical interview measures. Methods Four groups of participants aged 12–30 years were included (n = 218): AN, recovered AN (REC), ASD, and TD. Group differences on the Social Responsiveness Scale, 2nd edition (SRS-2), 10-item Autism Quotient (AQ-10), and the Autism Diagnostic Observation Schedule, 2nd edition (ADOS-2) were examined. To explore similarities and differences in specific symptom profiles associated with AN and ASD, individual item endorsement on the ADOS-2 was also examined in AN, REC, and ASD. Results Across measures, women with ASD showed the highest scores, and TDs the lowest. Generally, individuals with AN and REC showed intermediate levels of ASD symptoms, scoring between the other two groups. However, AN and ASD did not differ on restricted interests and repetitive behaviour subscales. The ADOS-2 item ‘quality of social response’ adequately discriminated between ASD and non-ASD participants. Limitations A full diagnostic assessment for ASD was not provided for participants with AN/REC, nor were eating disorders assessed in the ASD group. Therefore, some diagnostic overlap between groups is possible. The cross-sectional design is another limitation. Conclusions The results suggest similarities in scores on both self-report and clinical interview measures in AN and ASD. However, individual ADOS-2 item analyses also revealed subtle differences, particularly in reciprocal social interaction. ASD symptoms may be a combination of both state and trait features in AN.

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Section: Methodsmentioning

confidence: 99%

Autism symptoms in anorexia nervosa: a comparative study with females with autism spectrum disorder

et al. 2021

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“…In these studies, 40% of adolescents with AN had broader autism phenotype ( 45 ) and 26% of adults with AN had autistic features ( 46 ). It is thought that there may be a common pathogenesis between the AN and ASD, because some symptoms of ASD are observed in AN, such as misunderstanding social clues, difficulties in processing social information and providing appropriate response in interpersonal communication, and obsessive-compulsive features ( 9 , 47 ). Similar to those results in the literature, the findings of this study showed that the social awareness, social cognition, communication and social motivation are impaired in adolescents with AN, indicating that there may be a common pathogenesis between AN and ASD.…”

Section: Discussionmentioning

confidence: 99%

“…There have been many studies over the past few years documenting the relationship between AN and ASD, first identified by Gillberg in 1983 ( 8 ). Both conditions share a common profile of resistance to changes, social withdrawal and social disengagement, and show similar patterns of neurocognitive dysfunction including impaired set-shifting, weak central coherence, and impaired theory-of-mind (ToM) abilities ( 6 , 9 ). Patients with AN have also poor social and emotional functioning ( 10 , 11 ), including interpersonal relationship problems ( 7 ), reduced facial emotion expression ( 12 ), impaired facial emotion recognition ( 13 ), difficulties identifying emotions ( 10 ) and social anhedonia ( 3 ).…”

Section: Introductionmentioning

confidence: 99%

Autistic Traits and Social Responsiveness: The Relationship Between Autistic Traits and Comorbid Psychiatric Symptoms in Adolescents With Anorexia Nervosa

Kalaycı¹,

Nalbant²,

Akdemir³

2021

Archives of Neuropsychiatry

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Introduction: It is known that patients with anorexia nervosa (AN) display social difficulties like social responsiveness and high levels of autistic behaviors such as rigidity, narrow interests of food and weight; however it is not clear whether they have comorbid Autism Spectrum Disorders (ASD) or it is about acute phase of illness. In this study it is aimed to investigate autistic traits and social responsiveness in adolescents with AN. Methods: Study group was consisted of 39 female AN patients aged between 12-18 years. Control group was consisted of 34 female adolescents who did not have any psychiatric disorder. K-SADS-PL was applied to all participants in order to detect the psychiatric disorders. Autism traits and social responsiveness were evaluated using Social Responsiveness Scale. All adolescents of the study were administered The Eating Attitude Test, Beck Depression Inventory, Screen for Child Anxiety and Related Disorders, Maudsley Obsesive Compulsive Inventory. Results: Results of the study indicated that adolescents with AN had higher symptoms of depression, anxiety and autism-like symptom clusters; and lower social responsiveness. Psychiatric comorbidities were not associated with these difficulties. Conclusion: The results show that AN patients have an impairment of social responsiveness, the impairment seems to be associated with AN regardless of psychiatric comorbidities. Despite these two disorders are considered unrelated, they have several traits in common. These results suggest that there may be a common pathogenesis between ASD and AN.

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“…More recent studies have challenged their findings reporting no difficulties in theory of mind or facial affect recognition among people with AN (Dapelo et al, 2015;Ambwani et al, 2016;Kerr-Gaffney et al, 2020;Leslie et al, 2020). Some of the studies suggested that the previous reported findings of emotion recognition difficulties may reflect negative interpretation biases when labelling emotions (Dapelo et al, 2015;Ambwani et al, 2016).…”

Section: Introductionmentioning

confidence: 92%

Evaluation of film stimuli for the assessment of social-emotional processing

Leppänen¹,

Patsalos²,

Surguladze³

et al. 2021

Preprint

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Background: Social-emotional difficulties have been proposed to play a key role in the progression of psychiatric disorders, including anorexia nervosa. The aim of the current study was to build on existing work and develop more ecologically valid measures of interpretation biases and evoked emotional responses. Methodology: 124 healthy female participants aged 18 – 25 took part in the study. We evaluated two sets of 18 brief film clips to be used in two tasks assessing interpretation of ambiguous scenarios and reactions to emotionally provoking scenes. Written interpretations were coded, the valence of the interpretations was analysed, and an ambiguity check was conducted. Evoked facial affect and mood ratings in response to each film clip during the second, evoked emotions task were analysed using exploratory factor analyses. Results: Most of the film clips were interpreted in the expected neutral, positive, and negative manner while still retaining some ambiguity. However, participants were more attuned to the negative cues in the ambiguous film clips and three film clips were identified as unambiguous. The exploratory factor analyses showed that the positive and negative film clips used in the evoked emotions task formed their own factors as expected. However, there was substantial cross-loading of the neutral film clips when participants’ facial expression data was analysed.Discussion: A subset of the film clips evaluated here could be used to assess interpretation biases and evoked emotional responses among people with anorexia nervosa. Ambiguous negatively valenced film clips should have more subtle negative cues to ensure there is enough room for interpretation. Additionally, care should be taken to ensure optimal recording conditions if evoked facial expressions are to be assessed.

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Neural Correlates of Theory of Mind Are Preserved in Young Women With Anorexia Nervosa

Cited by 18 publications

References 39 publications

Autism symptoms in anorexia nervosa: a comparative study with females with autism spectrum disorder

Autism symptoms in anorexia nervosa: a comparative study with females with autism spectrum disorder

Autistic Traits and Social Responsiveness: The Relationship Between Autistic Traits and Comorbid Psychiatric Symptoms in Adolescents With Anorexia Nervosa

Evaluation of film stimuli for the assessment of social-emotional processing

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