An examination of the clinical outcomes of adolescents and young adults with broad autism spectrum traits and autism spectrum disorder and anorexia nervosa: A multi centre study

Abstract

Adolescents with AN and ASD traits show similar reductions in their eating disorder symptoms. Nevertheless, their social difficulties remain high suggesting that these are life-long difficulties rather than starvation effects.

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

“…Understanding the commonalities which link autism and anorexia nervosa seems imperative, given that autistic individuals and those with high autistic traits seem disproportionately over-represented in populations with this deadly disorder [5, 7, 17-20, 38-41, 43, 45, 48, 49, 55, 91] and seem to tend towards a poorer prognosis and treatment response [7][8][9][10][11]55]. We scrutinized the relationship between autistic traits and eating psychopathology with a focus on one putative mediating factor that might hypothetically serve as a risk factor for ED in autistic people and those with high autistic traits: levels of alexithymia.…”

“…A well-documented but poorly understood relationship exists between autism spectrum conditions (ASC) and anorexia nervosa (AN), conditions both associated with long-term morbidity and increased mortality [1][2][3][4]. The health risks associated with both conditions paint a worrying picture for the disproportionate number of autistic individuals found amongst those suffering from AN [5][6][7], as does the fact that autism and autistic traits seem to be associated with poorer prognosis and treatment response [7][8][9][10][11]. It is crucial to understand the mechanisms which may explain the heightened cooccurrence of these conditions and offer important insights to treatment.…”

“…One reason for the divergence may be different definitions of 'recovery'. However, the apparent fading away of autistic symptoms with age and/or recovery may reflect not only the influence of malnutrition but also the potentially poorer prognosis and slower or poorer treatment response of individuals with high autistic traits or diagnosed autism [7][8][9][10][11]-with these individuals thus more likely to be seen in adult services, this would explain the higher cooccurrence in older samples [55].…”

An illustration of collaborative care with a focus on the role of fathers in Maudsley Anorexia Nervosa Treatment for Adults (MANTRA)

“…Furthermore, these traits can become exacerbated by the starvation of the acute illness (Treasure, ) and add to the complexity of the illness. It is unclear whether these traits adversely affect outcome (Nazar et al, ) and whether treatment should be adjusted to cater for the specific needs of these individuals. Starvation produces autistic‐like features, exacerbating obsessive–compulsive traits, and reducing social cognition.…”

Exploring Relationships Between Autism Spectrum Disorder Symptoms and Eating Disorder Symptoms in Adults With Anorexia Nervosa: A Network Approach

“…It has been suggested that high levels of ASD traits found in a proportion of those with AN may be due to the effects of starvation, and do not represent true ASD (26). However, several studies have found that body mass index (BMI), which is often used as a measure of illness severity, is not associated with ASD traits in individuals with AN (27)(28)(29)(30)(31)(32)(33). A few of these studies also examined associations with illness duration, finding that those with high ASD traits had not been ill for a significantly longer period of time than those with low ASD traits (29,33).…”