The social responsiveness scale is an efficient screening tool for autism spectrum disorder traits in adults with anorexia nervosa

Abstract

Objective A significant proportion of individuals with anorexia nervosa (AN) show high levels of autism spectrum disorder (ASD) traits, a factor associated with poorer treatment outcomes. An important question for both researchers and clinicians relates to how ASD traits should be assessed in individuals with AN. This study aimed to examine scores on the Social Responsiveness Scale adult self‐report version (SRS‐2) in individuals in the acute (AN) and recovered stages (REC) of illness compared to healthy controls (HCs). We also aimed to examine associations between the SRS‐2 and an observational diagnostic measure, the Autism Diagnostic Observation Schedule ‐ second edition (ADOS‐2). Method The SRS‐2 and ADOS‐2 were administered to 142 adults with AN, REC, and HCs. Eating disorder (ED) psychopathology and functional impairment were also assessed. Results AN and REC scored significantly higher than HCs on the SRS‐2. SRS‐2 scores significantly predicted ADOS‐2 classification and were positively associated with ED psychopathology and functional impairment. SRS‐2 scores were not associated with BMI or illness duration. Conclusions The SRS‐2 may be a useful tool in screening for ASD traits in individuals with AN. Although cross‐sectional, the results also suggest ASD symptoms are independent of BMI and persist in individuals recovered from AN.

Autistic Traits Mediate Reductions in Social Attention in Adults with Anorexia Nervosa

“…Another limitation concerns our measure of ASD traits. The SRS-2 has been shown to predict scores on clinical interview measures of ASD such as the ADOS-2 in individuals with AN (Kerr-Gaffney et al 2020b ), however it is possible that scores on the SRS-2 are influenced by symptoms of anxiety, depression, or alexithymia. Our study may have benefitted from including a sub-group of participants with AN and a diagnosis of ASD to further clarify our results.…”

“…Total scores can also be converted into T -scores, which are interpreted as follows: ≤ 59 T , “normal”; 60–65 T , “mild”; 66–75 T , “moderate”; ≥ 76 T “severe” range. SRS-2 scores have been shown to be associated with functional impairment in individuals with AN, however scores are independent from indicators of malnutrition such as BMI and illness duration (Kerr-Gaffney et al 2020b ). Cronbach’s alpha was 0.96.…”

‘It’s not that they don’t want to access the support . . . it’s the impact of the autism’: The experience of eating disorder services from the perspective of autistic women, parents and healthcare professionals

“…While the AQ-10 is recommended as an autism screening tool (NICE, 2016) and endorsed in its use in AN populations (Westwood et al, 2016), other research has suggested that the measure may not be an effective tool to use in a clinical population, with particular concern being raised with its use in AN populations (Kerr-Gaffney et al, 2020;Sedgewick et al, 2019), which has implications for the validity of the AQ-10 used within the current study. Moreover, our sample's low internal consistency contrasts with that reported by the developers of the AQ-10 ( Allison et al, 2012), who reported a Cronbach's alpha of 0.85.…”

Neuropsychological and clinical findings of Cognitive Remediation Therapy feasibility randomised controlled trial in young people with anorexia nervosa

“…However, the ASC subgroup in this study was small and was defined only through the SRS scores and not based on a formal assessment. Although SRS proved to be a useful and reliable tool for the screening of ASC traits in adults with AN (Kerr‐Gaffney et al., 2020), this finding has not been replicated yet in YP. It would be important that future studies could screen the presence of ASC in YP with AN and explore tailored interventions, including CRT.…”