Social Cognition in Anorexia Nervosa: Evidence of Preserved Theory of Mind and Impaired Emotional Functioning

Abstract

BackgroundThe findings of the few studies that have to date investigated the way in which individuals with Anorexia Nervosa (AN) navigate their social environment are somewhat contradictory. We undertook this study to shed new light on the social-cognitive profile of patients with AN, analysing Theory of Mind and emotional functioning. Starting from previous evidence on the role of the amygdala in the neurobiology of AN and in the social cognition, we hypothesise preserved Theory of Mind and impaired emotional functioning in patients with AN.MethodologyThirty women diagnosed with AN and thirty-two women matched for education and age were involved in the study. Theory of Mind and emotional functioning were assessed with a set of validated experimental tasks. A measure of perceived social support was also used to test the correlations between this dimension and the social-cognitive profile of AN patients.Principal FindingsThe performance of patients with AN is significantly worse than that of healthy controls on tasks assessing emotional functioning, whereas patients’ performance is comparable to that of healthy controls on the Theory of Mind task. Correlation analyses showed no relationship between scores on any of the social-cognition tasks and either age of onset or duration of illness. A correlation between social support and emotional functioning was found. This latter result seems to suggest a potential role of social support in the treatment and recovery of AN.ConclusionsThe pattern of results followed the experimental hypothesis. They may be useful to help us better understand the social-cognitive profile of patients with AN and to contribute to the development of effective interventions based on the ways in which patients with AN actually perceive their social environment.

Social cognition in anorexia nervosa: Specific difficulties in decoding emotional but not nonemotional mental states

“…Building on the partial phenomenological overlap between AN and autism spectrum disorders (where impaired social cognition constitutes a hallmark feature), several studies have examined social cognition in AN. These studies have shown a reduced ability to infer others' emotions and cognitions from their faces and voices with tentative evidence suggesting that the inference of emotions may be more affected than the inference of cognitions . Two meta‐analyses confirmed the presence of impaired recognition of (particularly complex as opposed to basic) emotions in others and in higher‐level mental state inference in AN.…”

Intact social cognitive processes in outpatients with anorexia nervosa: a pilot study

“…In contrast, other studies have found no significant differences in decoding of emotional facial expressions in eating disordered individuals compared to healthy groups [2, 31], and any differences in levels of empathy compared to healthy controls groups [13]. Moreover, there is a growing body of literature showing intact social cognitive functioning in partially remitted patients with AN [23, 24].…”

Seeing things differently: An experimental investigation of social cognition and interpersonal behavior in anorexia nervosa

“…[1][2][3][4][5]. 9 Interpersonal problems not only have important implications for one's quality of life and psychological well-being, 10 but these difficulties are linked with lower perceived social support 11 and predict poorer treatment outcomes 12,13 for individuals with EDs. 6 Moreover, studies suggest that not only do individuals with EDs experience greater interpersonal problems overall, 7 but they also experience a general hypersensitivity to interpersonal interactions 8 and a tendency to compare and evaluate themselves more harshly with respect to interpersonal abilities.…”

“…14 It requires an ability to represent the intentions and beliefs of others accurately 11 and the capacity to share the emotions and feelings of others. 14 It requires an ability to represent the intentions and beliefs of others accurately 11 and the capacity to share the emotions and feelings of others.…”