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

Kerr-Gaffney, Jess; Mason, Luke; Jones, Emily J. H.; Hayward, Hannah; Harrison, Amy; Murphy, Declan; Tchanturia, Kate

doi:10.1007/s10803-020-04686-y

Cited by 15 publications

(20 citation statements)

References 113 publications

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“…While social motivation has received less attention in eating disorder research, recent behavioural evidence complements our findings. Individuals with AN show reductions in social attention [ 73 , 74 ], derive less pleasure from social interactions [ 75 ], and find social information less rewarding, compared to TD [ 76 ]. Whether similar brain processes underlie reduced social motivation in AN and ASD is an interesting question for future research.…”

Section: Discussionmentioning

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: Discussionmentioning

confidence: 99%

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

et al. 2021

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“…Some evidence also suggests that reductions in attention to faces predict the degree of social impairment and emotion recognition difficulties in people with ASD ( Corden et al, 2008 ; Falkmer et al, 2011 ; Müller et al, 2016 ). Accordingly, a small number of studies have begun to investigate social attention in individuals with AN, finding reductions in attention to faces ( Kerr-Gaffney, Mason, et al, 2021 ; Watson et al, 2010 ) and eyes ( Harrison et al, 2019 ) compared with the controls. One of these studies demonstrated that reductions in attention to faces in AN were fully mediated by self-reported ASD symptoms ( Kerr-Gaffney, Mason, et al, 2021 ).…”

Section: Introductionmentioning

confidence: 99%

Social attention in anorexia nervosa and autism spectrum disorder: Role of social motivation

Kerr-Gaffney

Jones

Mason

et al. 2021

Autism

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Research suggests a relationship between anorexia nervosa and autism spectrum disorder. The aim of the current study was to examine social attention in anorexia nervosa and autism spectrum disorder compared with age- and sex-matched typically developing groups, and to examine whether lowered social motivation could explain reductions in social attention across the two disorders. Participants’ eye movements were tracked while watching a dynamic social scene. The proportion of fixation duration to faces, bodies and non-social areas of interest were compared across groups. Participants with autism spectrum disorder looked at faces significantly less often than controls, however, there were no differences between anorexia nervosa and controls in attention to faces. Typically developing -normed z-scores indicated that attention to faces showed the greatest deviation from normative data compared with body or non-social areas of interest in both autism spectrum disorder and anorexia nervosa, however, differences were larger in autism spectrum disorder than in anorexia nervosa. Social motivation scores did not predict attention to faces in either autism spectrum disorder or anorexia nervosa. Our results do not support the hypothesis that differences in social motivation underlie reduced social attention in both anorexia nervosa and autism spectrum disorder. Lay abstract Research suggests a relationship between autism and anorexia nervosa. For example, rigid and inflexible behaviour, a preference for routine and social difficulties are seen in both conditions. In this study, we examined whether people with anorexia and people with autism show similarities in social attention (where they look while engaging in social interactions or watching a scene with people interacting). This could help us understand why people with anorexia and autism experience difficulties in social situations. Participants with either anorexia or autism, as well as participants with no mental health problems watched a video of a social scene while we recorded which parts of the scene they looked at with an eye-tracker. Participants also completed questionnaires to assess characteristics of autism. We found that autistic participants looked at faces less than typically developing participants. However, participants with anorexia did not show a similar reduction in attention to faces, contrary to our predictions. Autistic features were not related to attention in either group. The results suggest that autistic people may miss important social cues (like facial expressions), potentially contributing to social difficulties. However, this mechanism does not appear explain social difficulties in people with anorexia.

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“…Here, we also observed social cognitive differences between the pwAN and wrAN cohorts in two subscales of the social problem solving inventory, with more negative and less positive problem-solving orientations, as assessed with the NPO and PPO subscales of the SPSI-R, for the pwAN cohort relative to wrAN, and both cohorts relative to HC. Clinically, problems with mentalization and non-verbal social communication have been observed in patients with AN [50][51][52], and interventions that target social-emotional function are being explored in anorexia nervosa. Cognitive remediation and emotional skill training (CREST) augments treatment of severe AN, addressing social anhedonia, alexithymia, and quality of life [53,54].…”

Section: Discussionmentioning

confidence: 99%

Structural brain differences in recovering and weight-recovered adult outpatient women with anorexia nervosa

et al. 2021

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Background Anorexia nervosa is a complex psychiatric illness that includes severe low body weight with cognitive distortions and altered eating behaviors. Brain structures, including cortical thicknesses in many regions, are reduced in underweight patients who are acutely ill with anorexia nervosa. However, few studies have examined adult outpatients in the process of recovering from anorexia nervosa. Evaluating neurobiological problems at different physiological stages of anorexia nervosa may facilitate our understanding of the recovery process. Methods Magnetic resonance imaging (MRI) images from 37 partially weight-restored women with anorexia nervosa (pwAN), 32 women with a history of anorexia nervosa maintaining weight restoration (wrAN), and 41 healthy control women were analyzed using FreeSurfer. Group differences in brain structure, including cortical thickness, areas, and volumes, were compared using a series of factorial f-tests, including age as a covariate, and correcting for multiple comparisons with the False Discovery Rate method. Results The pwAN and wrAN cohorts differed from each other in body mass index, eating disorder symptoms, and social problem solving orientations, but not depression or self-esteem. Relative to the HC cohort, eight cortical thicknesses were thinner for the pwAN cohort; these regions were predominately right-sided and in the cingulate and frontal lobe. One of these regions, the right pars orbitalis, was also thinner for the wrAN cohort. One region, the right parahippocampal gyrus, was thicker in the pwAN cohort. One volume, the right cerebellar white matter, was reduced in the pwAN cohort. There were no differences in global white matter, gray matter, or subcortical volumes across the cohorts. Conclusions Many regional structural differences were observed in the pwAN cohort with minimal differences in the wrAN cohort. These data support a treatment focus on achieving and sustaining full weight restoration to mitigate possible neurobiological sequela of AN. In addition, the regions showing cortical thinning are similar to structural changes reported elsewhere for suicide attempts, anxiety disorders, and autistic spectrum disorder. Understanding how brain structure and function are related to clinical symptoms expressed during the course of recovering from AN is needed.

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

Cited by 15 publications

References 113 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

Social attention in anorexia nervosa and autism spectrum disorder: Role of social motivation

Structural brain differences in recovering and weight-recovered adult outpatient women with anorexia nervosa

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