Impact of ASD Traits on Treatment Outcomes of Eating Disorders in Girls

Abstract

Evidence links high levels of Autism Spectrum Disorder Traits in women with chronicity of anorexia nervosa. This study reports through clinical audit the impact of ASD traits on treatment outcomes of girls who were referred for treatment in a specialist eating disorder service. Presence of current, but not early childhood, ASD traits was elevated in comparison with previously reported community samples. Current ASD traits were correlated with emotional disorders and with need for treatment augmentation (psychiatric inpatient or day patient admission), but this relationship was not significant after the contribution of depression had been controlled for. There was no difference in Morgan Russell Outcomes at discharge for those with high and low current ASD traits. Parent-reported ASD-related developmental difficulties were associated with attenuated change in self-reported cognitive symptoms of AN. This study highlights the need for further understanding of the aetiology, diagnostic significance and predictive utility for future relapse of elevated ASD traits in childhood eating disorders. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.

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

“…The 15.4% (23/149) prevalence of SAS scores below cut-off (ASD traits group) in this sample is the same as that found in a clinical cohort of AN and EDNOS cases (Stewart et al, 2017). However, the computer generated probability of ASD diagnosis from the DAWBA in the clinical cohort (Stewart et al, 2017) did not differ from community norms, while in our sample, a trained psychiatrist reviewed the DAWBA and we found one probable and five possible cases (Rhind et al, 2014).…”

“…The clinical cohort (Stewart et al, 2017) included people with an age range of 9-18 (mean 5 14.6), whereas the current study included people from age 13-21 years (mean 5 17). Previous studies suggest that the prevalence of ASD traits varies according to the age/duration of illness of the sample included.…”

“…In a Swedish cohort of AN adolescents, 32% had ASD traits at some time over the course of 18 years follow-up and this sub-group had a poorer long term prognosis (Anckarsäter et al, 2012), with particular problems in mental and social functioning (Nielsen et al, 2015). In a series of AN cases referred to a specialized child and adolescent service, 6.9% had broad ASD traits (using the autism-spectrum quotient) and this sub-group were more likely to progress to more intensive levels of care (day or inpatient) (Stewart, McEwen, Konstantellou, Eisler, & Simic, 2017). In line with these findings, we have previously reported that 19% of AN adolescents presenting for treatment had ASD traits with 4% receiving a probable/possible ASD diagnosis (Rhind et al, 2014).…”

Same behaviours, different reasons: what do patients with co-occurring anorexia and autism want from treatment?

“…Potential mechanisms underlying the relationship between AN and autism could include shared cognitive traits: commonly with research in autism, literature shows that people with AN exhibit problems with rigidity, central coherence, and emotional and social processing that may persist following recovery (Harrison, Mountford, & Tchanturia, 2014;Lang, Lopez, Stahl, Tchanturia, & Treasure, 2014;Katie Lang et al, 2016;Leppanen, Sedgewick, Treasure, & Tchanturia, 2018;Westwood, Lawrence, Fleming, & Tchanturia, 2016;Westwood, Stahl, Mandy, & Tchanturia, 2016). Significantly, heightened autistic traits in people with AN are associated with more severe presentations and poorer treatment outcomes (Nielsen, Anckarsater, Gillberg, Rastam, & Wentz, 2015;Tchanturia, Adamson, Leppanen, & Westwood, 2017;Tchanturia, Larsson, & Adamson, 2016), leading to suggestions that traditional treatment approaches may need to be adapted for this population (Dudova, Kocourkova, & Koutek, 2015;Stewart, McEwen, Konstantellou, Eisler, & Simic, 2017;. Treasure, 2013).…”

Autistic traits in mentalization‐based treatment for concurrent borderline personality disorder and substance use disorder: Secondary analyses of a randomized controlled feasibility study

“…Furthermore, treatment could be exacerbated due to problems with patient‐therapist communication, deficits in metacognition, and emotional understanding (Grainger, Williams & Lind, ; Kinnaird, Norton & Tchanturia, ; Losh & Capps, ). Previous research on treatment outcomes in eating disorders showed that patients with concurrent ASD, elevated levels of ASD traits or ASD‐related developmental difficulties responded less successfully to treatment, compared to patients without concurrent ASD and low ASD traits, respectively (Nielsen et al ., ; Stewart, McEwen, Konstantellou, Eisler & Simic, ; Tchanturia, Larsson & Adamson, ). In SUD, conventional treatment methods might not be appropriate for patients with concurrent ASD, like for example group therapy because of deficits in social skills as well as distress and anxiety potentially evoked by group settings (Arnevik & Helverschou, ; Drake, Hank, Edwards, Ensum & Bateman, ; Rengit et al ., ).…”