Autism and anorexia nervosa: Longitudinal prediction of eating disorder outcomes

Abstract

BackgroundRecently, elevated levels of autistic features and autism diagnoses have been reported among people with anorexia nervosa (AN). In clinical settings high levels of autistic features have been linked to more complex, highly comorbid illness presentation and poorer treatment outcome. This study aimed to examine whether autistic features predict AN symptom profile in long term.MethodsAltogether 118 women with lived experience of AN completed two autism assessments at time 1, the Autism Diagnostic Observation Schedule (ADOS) and the short version of the Autism Quotient (AQ10). Measures assessing AN symptom profile, including eating disorders symptoms, anxiety, depression, OCD symptoms, and Body Mass Index (BMI), were also recorded. The symptom profile measures were administered again 6 months and 2 years later. We conducted two analyses to examine the extent to which the ADOS and AQ10 scores predicted broad AN symptom profile at each three time points.ResultsOverall, high levels of autistic features were consistently associated with worse psychological symptoms, but not BMI, across all time points. Both the analysis using baseline ADOS scores and self-reported AQ10 scores showed similar pattern.ConclusionThe present findings consolidate previously reported associations between autistic features and worse psychological outcome among people with AN. The findings also suggest that self-report measures may be sufficient for assessing the impact of autistic features on illness outcome among people with AN. Importantly, the study highlights the need for development and further investigation of neurodiversity accommodations in the treatment of AN.

Essstörungen und psychische Komorbidität

“…Die Häufigkeit der Komorbidität von ES mit Suchterkrankungen, Zwangs-, Angst- und depressiven Störungen liegt bei über 50% 1 6 . Werden solche Komorbiditäten übersehen, kann keine angemessene Behandlung erfolgen und entsprechend geringer sind die Erfolgsaussichten 7 . Noch drastischer können die Auswirkungen einer unzureichenden oder falschen Diagnostik jedoch sein, wenn Komorbiditäten aus dem Bereich der Persönlichkeitsstörungen (z.…”

A call for autism‐led research exploring definitions of recovery in Autistic individuals with an eating disorder

“…Including Autistic individuals as active participators in the research process opens many novel avenues for autism research and encourages a shift toward research being conducted by or with Autistic people as opposed to being conducted on them (Milton & Maclean, 2013). Generating clear understandings of recovery in Autistic individuals with EDs will also benefit the delivery of ED treatment, something particularly pertinent in light of poorer treatment and recovery outcomes (e.g., Leppanen et al, 2022; Nielsen et al, 2022). Establishing clear recovery definitions prior to ED treatment may improve engagement, reduce potentially harmful practice, and improve outcomes for Autistic individuals across inpatient, outpatient services and community services.…”

“…There is also increasing evidence to suggest that Autistic individuals report more severe ED psychopathology and complex psychological comorbidities (Leppanen et al, 2022; Stewart et al, 2017; Tchanturia et al, 2019) and thus may represent some of the most severely ill ED patients. This could provide researchers with challenges regarding a lack of access to participants .…”

“…Autistic traits are over‐represented across different ED diagnoses, including BN and BED (Gesi et al, 2020), ARFID (Bourne et al, 2022; Inoue et al, 2021), and in around 30% of AN samples (Westwood & Tchanturia, 2017). However, until recently, research settings have typically not assessed or controlled for autism, leading to highly heterogenous picture of treatment and recovery outcomes (Leppanen et al, 2022; Li et al, 2021; Nazar et al, 2018; Nielsen et al, 2022; Tchanturia et al, 2019). In order to support and improve rates of ED recovery in Autistic individuals, it is important to clarify just what is meant by the term “recovery,” and what this means to Autistic individuals.…”

Clinical Reflections and Treatment Adaptations for Avoidant Restrictive Food Intake Disorder: A Case Study

“…Although recognised as a distinct category, ARFID research is relatively scarce, further complicating treatment planning. Research in treatment outcomes demonstrates that autistic people with an eating disorder had longer overall hospital stays, higher anxiety and depression levels and poorer outcomes upon discharge (Tchanturia et al, 2019; Li et al, 2022; Leppanen et al, 2022). Therefore, further research is warranted at the intersect of ARFID and autism to better inform treatment (Koomar et al, 2021).…”