Social cognition in anorexia nervosa: Specific difficulties in decoding emotional but not nonemotional mental states

Abstract

Objective: Building on recent models of anorexia nervosa (AN) that emphasize the importance of impaired social cognition in the development and maintenance of the disorder, the present study aimed at examining whether women with AN have more difficulties with inferring other people's emotional and non-emotional mental states than healthy women. Results: Women with AN showed poorer emotional mental state inference, whereas non-emotional mental state inference was largely intact. Groups did not differ in undermentalizing (overly simplistic theory of mind) and overmentalizing (overly complex or over-interpretative mental state reasoning).Performance in the MASC was independent of levels of eating disorder psychopathology and symptoms of depression and anxiety. Discussion:The findings suggest that AN is associated with specific difficulties in emotional mental state inference despite largely intact non-emotional mental state inference. Upon replication in larger samples, these findings advocate a stronger emphasis on socio-emotional processing in AN treatment.

Psychopharmacological advances in eating disorders

“…Another hormone which could be relevant in the development of EDs is the neuropeptide hormone oxytocin which has been shown to inhibit food intake and to increase energy expenditure in animals [117,118]. It is released into systemic circulation in situations of psychosocial interaction, and has been shown to be involved in mechanisms of social bonding and social recognition [117,118], areas where patients with AN show specific difficulties [119], and to be a possible mediator of SSRI-induced antidepressant effects [120].…”

“…Other novel approaches could be drugs which improve social relationships or learning to enhance the effects of psychotherapy for EDs. In this respect, we would like to refer again to oxytocin [117][118][119][120] and D-cycloserine [133].…”

“Walk a mile in my shoes”. Mentalising ability in patients with eating disorders – literature review „Przejdź milę w moich butach”. Umiejętność mentalizacji u pacjentów z anoreksją i bulimią – przegląd literatury

“…Further evidence regarding the role of mentalising ability in patients with AN was provided by Brockmeyer et al (2016). They examined a sample of n = 25 women with AN, who were matched with a comparison group with n = 25 non-clinical female participants.…”

“…The hypothesised advantage of this task in comparison to other tasks measuring mentalising ability (e.g. "Reading the mind in the eyes"; Brockmeyer et al 2016) is that it not only allows for inference of mental states in a situation that is proximal to a real-life-situation, thus being ecologically valid, but also allows for the scoring of cognitive and emotional mental states separately (Brockmeyer et al 2016). The questions addressed topics such as: mental states of the characters involved in the interaction, the nature of the relationships between them, their mutual level of intimacy, and personality characteristics (e.g.…”

“…According to Smith and Semin (2007), social cognition refers to "mental representations and processes that underlie social judgment and behaviour". Brockmeyer et al (2016) proposed that some symptoms of eating disorders, such as purging or restraining from food, may serve as maladaptive strategies to compensate for impaired social cognition and aim at reducing social threat.…”