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

Abstract

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.

Positive communication workshops: are they useful for treatment programmes for anorexia nervosa?

“…Findings from the pre-workshop questionnaire suggest that the patients attending the workshop were aware of their difficulties in social interactions, such as finding social situations difficult and having problems with eye contact, expressing emotions and engaging in social communication. This is in line with findings from experimental studies demonstrating that individuals with AN show significantly less eye contact than healthy controls (Harrison et al, 2018), they also spend less time watching social stimuli (Kerr-Gaffney et al, 2022). As expected, we found a large effect size difference in participant's self-reported ratings of the importance and their confidence in using eye contact, tone of voice, body language in the communication; suggesting that participants found all key elements of effective communication important but were not confident using this knowledge in real life situations.…”

Attention Biases for Eating Disorder-Related Stimuli Versus Social Stimuli in Adolescents with Anorexia Nervosa – An Eye-Tracking Study

“…Through these mechanisms, the biases found in the present study could have an additional indirect negative effect on ED psychopathology. Of note, it has been suggested that different mechanisms may explain reduced attention to social cues in AN and autism spectrum disorders (Kerr-Gaffney et al, 2022). The present study might help to shed light on these different mechanisms as it indicates that increased attention to disorder-related characteristics of people (i.e., their bodies) might underlie the reduced attention to their faces in individuals with AN while probably other mechanisms (as for example attempts to reduce overstimulation or stress; Kerr-Gaffney et al, 2022) are responsible for the reduced attention to faces in individuals with autism spectrum disorders.…”

“…Of note, it has been suggested that different mechanisms may explain reduced attention to social cues in AN and autism spectrum disorders (Kerr-Gaffney et al, 2022). The present study might help to shed light on these different mechanisms as it indicates that increased attention to disorder-related characteristics of people (i.e., their bodies) might underlie the reduced attention to their faces in individuals with AN while probably other mechanisms (as for example attempts to reduce overstimulation or stress; Kerr-Gaffney et al, 2022) are responsible for the reduced attention to faces in individuals with autism spectrum disorders. However, in the present study pictures of faces were always presented alongside pictures of bodies (i.e., highly relevant disorder-related stimuli) so it remains unknown whether adolescents with AN would also look less at faces in the absence of disorder-related information (as found in adults with AN: Fujiwara et al, 2017;Kerr-Gaffney et al, 2021).…”

Characterising illness stages and recovery trajectories of eating disorders in young people via remote measurement technology (STORY): a multi-centre prospective cohort study protocol

“…Response latency, time to first fixation and fixation duration are collected to assess attentional biases toward food cues. ▶ Two naturalistic scenes: Participants view a 124-s clip from the 1995-film ‘Welcome to the Dollhouse’ depicting a social situation of a young female attempting to find a table in a school cafeteria [ 71 ], followed by a 40-s clip of people being interviewed in the street [ 72 ]. During both videos, eye-tracking data will be collected to measure social attention and comprehension .…”